Radical Retropubic Prostatectomy on Outpatient Basis
Keywords:Prostate cancer, retropubic prostatectomy, day care, hospital costs, ambulatory surgical procedures.
Introduction: This study evaluated the possibility of performing in our midst the open radical prostatectomy with discharge on the same day of the procedure, aiming the improvement of postoperative recovery and reduce hospital costs without loss of quality of care, or decreased patient satisfaction with treatment.
Patients and Methods: We selected 27 patients with localized prostate cancer during the period from April 2011 to January 2012, which had a low surgical risk and opted for the open radical prostatectomy. We evaluated the feasibility of outpatient open radical prostatectomy, perioperative complications, and patient satisfaction with treatment.
Results: Eleven (40.7%) patients were discharged on the same day of the procedure; thirteen were discharged in the morning after surgery and three in the second postoperative day. All patients underwent general anesthesia. The use of opioids in safe doses for epidural anesthesia was administered in 13 patients, improving pain control and enabling early discharge in 8 (61.5%) patients. Only 3 (21.4%) patients who did not receive epidural opioid achieved discharge on the same day of surgery (p = 0.04). No patient had a major complication or was readmitted to the hospital. There was no difference in patient satisfaction with treatment between the group of the same day surgery and the patients with longer hospitalization.
Conclusion: The open radical prostatectomy can be performed with safety on an outpatient basis, in properly selected patients, with no decrease in patient satisfaction with treatment.
Brasil. Ministério do Brasil. Instituto Nacional de Câncer. Estimativa 2012: incidência de câncer no Brasil
Brasil. Ministério do Brasil. Departamento de Informação do SUS. Morbidade Hospitalar do SUS - por local de internação – Brasil
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