%0 Journal Article
%T Day-case robotic-assisted partial nephrectomy: feasibility and preliminary results of a prospective evaluation (UroCCR-25 AMBU-REIN study).
%A Bernhard JC
%A Robert G
%A Ricard S
%A Michiels C
%A Capon G
%A Boulenger de Hautecloque A
%A Bensadoun H
%A Gay J
%A Rogier J
%A Tauzin-Fin P
%A Gross-Goupil M
%A Benard A
%A Nouette K
%A Roullet S
%A Ferrière JM
%J World J Urol
%V 0
%N 0
%D Jun 2020 8
%M 32514670
%F 3.661
%R 10.1007/s00345-020-03283-z
%X <B>OBJECTIVE: </B>Robotic partial nephrectomy (RPN) is a minimally-invasive technique used to treat renal tumors. A clinical pathway and prospective research protocol (AMBU-REIN) were specifically set up to establish and assess the routine use of day-case RPN.<BR><B>METHODS: </B>The AMBU-REIN study was conducted in the framework of the French research network on kidney cancer UroCCR (NCT03293563). We present our initial experience of patients treated using day-case RPN and released from our hospital on the same day, focusing on patient selection, safety and patient satisfaction using the EVAN-G validated questionnaire.<BR><B>RESULTS: </B>Between September 2016 and September 2019, 429 RPN were performed and 82 patients were consecutively selected for day-case RPN. Patients were managed using transperitoneal RPN with off-clamp tumorectomy for 66/82 cases. Mean tumor size was 2.7 ± 1.2 cm. There were no immediate severe postoperative complications; 7/82 patients were kept under observation overnight and discharged the following day. The follow-up at day 30 indicated postoperative complications, readmissions, and mortality rates of 1.2, 1.2, and 0%, respectively. Next-day patient satisfaction questionnaires indicated that patients were generally highly satisfied, with a mean ± standard deviation global score of 83.6 ± 10.3%. "Attention" was rated the highest overall (mean 94.8 ± 10.5%), while "pain management" scored the lowest (61.2 ± 20.5%).<BR><B>CONCLUSIONS: </B>This prospective case series is the first to demonstrate the safety and feasibility of day-case RPN. For selected patients and through a dedicated, nurse-led clinical pathway, it provided a high level of patient satisfaction. Expected benefits on healthcare cost savings warrant further investigation.