Ambulatory Robot-Assisted Laparoscopic Prostatectomy: Is It Ready for Prime Time? A Quality of Life Analysis

摘要

Purpose: To investigate the difference, if any, in the quality of life (QoL) at specified intervals in patients undergoing same day discharge (SDD, ambulatory) vs next day discharge (NDD) after robot-assisted laparoscopic prostatectomy (RALP). Materials and Methods: Two hundred consecutive patients underwent RALP with either SDD or NDD. They completed validated pain and health-related QoL questionnaires at predefined intervals postoperatively and results were compared between the two groups. Results: Pearson's coefficient revealed significant correlations between the time of discharge and physical well-being ( r = −0.139; p = 0.005), emotional well-being (EWB) ( r = −0.71; p < 0.001), functional assessment of cancer therapy-general (FACT-G) ( r = −0.367; p < 0.001), functional assessment of cancer therapy-prostate (FACT-P) ( r = −0.273; p < 0.001), pain severity score (PSS) ( r = 0.237; p < 0.001), and pain interference score (PIS) ( r = 0.214; p < 0.001). Student's t -test revealed significant ( p < 0.001) difference in the means of PSS, PIS, EWB, FACT-G, and FACT-P between both groups. Time of discharge was found to be an independent significant predictor ( p < 0.01) of PSS and PIS. Pearson's coefficients revealed that PSS had significant correlations with age ( r = −0.60; p < 0.001), body mass index ( r = 0.87; p < 0.001), and console time (CT) ( r = 0.63; p < 0.001). CT also correlated with the estimated blood loss ( r = 0.65; p < 0.001). Conclusions: Patients who were discharged the same day as their RALP had lesser pain and interference in general activity scores 2 days after discharge and had better perceived overall health than patients who were discharged on postoperative day 1.