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World J Urol. 2016 Jun;34(6):883-7. doi: 10.1007/s00345-015-1746-6. Epub 2015 Dec 16.

Are we ready for day-case partial nephrectomy?

Author information

1
Department of Urology and Kidney Transplant, CHU Bordeaux, University of Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France. jcb31000@hotmail.com.
2
French Research Network on Kidney Cancer UroCCR, Bordeaux, France. jcb31000@hotmail.com.
3
Anesthesiology Department, CHU Bordeaux, University of Bordeaux, Bordeaux, France.
4
Department of Urology and Kidney Transplant, CHU Bordeaux, University of Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France.
5
French Research Network on Kidney Cancer UroCCR, Bordeaux, France.
6
Radiology Department, CHU Bordeaux, University of Bordeaux, Bordeaux, France.
7
Medical Oncology Department, CHU Bordeaux, University of Bordeaux, Bordeaux, France.

Abstract

Fast-track and day-case surgeries are gaining more and more importance. Their development was eased by the diffusion of minimal invasive surgical strategies and the consequential morbidity reduction. In the field of kidney cancer, seven cases of ambulatory radical nephrectomy were previously reported in the international literature. Regarding robotic partial nephrectomy (PN), short postoperative pathways resulting in patients' discharge on postoperative day 1 were shown to be safe and feasible. We report our initial experience of robot-assisted PN discharged on postoperative day zero and discuss the criteria for adequate patient selection. Indeed, outpatient PN will obviously not be suitable for all patients, and careful selection will be mandatory. Both specific baseline patient's factors and postoperative events will have to be recognized for the first ones and prevented for the second ones. Safety, patient satisfaction, cost efficiency, and reproducibility will be the key factors to assess and promote day-case PN.

KEYWORDS:

Day-case; Kidney cancer; Outpatient; Partial nephrectomy; Robotic assistance

PMID:
26676613
DOI:
10.1007/s00345-015-1746-6
[Indexed for MEDLINE]

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