DAY SURGERY SEMINAL-SPARING OPEN RADICAL PROSTATECTOMY
Objectives: to assess the safety of hospital discharge 24h after minimaly invasive radical prostatectomy (seminal-nerve sparing open radical prostatectomy, with no lymphadenectomy). Herein we report our selection criteria, discharge criteria and patients satisfaction.
Methods: we performed a prospective study with 8 patients undergoing open seminal-nerve sparing radical prostatectomy, using Erbeject 2 for the neurovascular bundles hydrodissection, in spinal anesthesia with Bupivacaine 12,5 mg alone.
Post-operative analgesic protocol consisted of oral oxycodone/naloxone (10 mg every 12 for 3 days+ paracetamol 1g if necessary.
Oncological criteria for patients selection were: low risk prostatic cancer (PSA <10, cT1c-T2, Gleason score <7, positive core biopsy <33%), MRI negative for extracapsular extension. All patients were directely discharged to their home under the care of a family member and with integrated home nurse care for two days. Patients was descharged only if they met the following requirements: absence of complication, dreinage debit less than 100 ml, normal oral tolerance and good functional recovery. Results: Mean patients age was 63 years. Mean operative time was 118 minutes and estimated blood loss was 245 mL. 7/8 patients were successfully discarged the day after surgery. One patients had a prolonged lenght of stay for persistent haematuria. Satisfaction was unanimously high in all patients surveyed. Discussion: early hospital discharge of patients who underwent open seminal-nerve sparing radical prostatectomy is feasible and safe. With Erbeject 2 use is possible to performe minimaly invasive radical prostatectomy, reducing the risk of blood loss. Conclusions: We belive that day surgery open prostatectomy is a good option for selected patients and decrease overall healthcare costs. ==fine abstract==