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Objective <p>To compare perioperative outcomes between the 48-h short-stay pathway and traditional inpatient management for patients undergoing robot-assisted partial nephrectomy (RAPN), and to evaluate the feasibility, safety, recovery efficiency, and economic benefits of the 48-h short-stay pathway.</p> Methods <p>This retrospective study included 175 patients who underwent RAPN between February 2022 and June 2024. Patients were assigned to a 48-h short-stay group (n = 60) or a traditional inpatient group (n = 115). A 1:1 propensity score matching (PSM) was conducted to balance baseline characteristics, including age, sex, BMI, comorbidities, tumor features, surgeon identity, and surgical year. Perioperative outcomes, recovery indicators, complications, and medical costs were compared.</p> Results <p>After PSM, 53 matched pairs were analyzed. The short-stay group showed significantly shorter operative time, less intraoperative blood loss, shorter warm ischemia time, earlier mobilization, earlier oral intake, faster bowel function recovery, and shorter bed rest (all <i>P</i> &lt; 0.05). The short-stay group had 71.7% of patients discharged on postoperative day (POD) 1 and 100% within 48&#xa0;h, while the traditional group had 22.6% on POD1, 33.96% on POD2, and 43.4% on POD ≥ 3 (<i>P</i> &lt; 0.001). Both total and postoperative hospital stays were significantly shorter in the short-stay group (2.00 vs. 6.00&#xa0;days, P &lt; 0.001), with lower hospitalization costs (<i>P</i> &lt; 0.001). Postoperative creatinine was lower in the short-stay group (<i>P</i> = 0.023), while creatinine change was comparable (<i>P</i> = 0.063). Complication rates, emergency department visits, and 30-day readmission rates were similar between groups (all <i>P</i> &gt; 0.05). The short-stay group had a significantly lower drain placement rate (<i>P</i> = 0.002) without increased adverse events.</p> Conclusion <p>The 48-h short-stay pathway for selected patients undergoing RAPN is feasible and safe. It accelerates postoperative recovery, shortens hospital stay, reduces medical costs, and optimizes healthcare resource utilization, without compromising safety or oncological early outcomes.</p>

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Evaluating the feasibility and safety of 48-h short-stay pathway for robot-assisted laparoscopic partial nephrectomy: a propensity score-matched analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月2日

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  • Caihong Tang,
  • Ningping Chu,
  • Chenghao Shi,
  • Zhongwen Chang,
  • Taoyue Zhao,
  • Hong He,
  • Yiman Zhang,
  • Lingling Jing

摘要

Objective

To compare perioperative outcomes between the 48-h short-stay pathway and traditional inpatient management for patients undergoing robot-assisted partial nephrectomy (RAPN), and to evaluate the feasibility, safety, recovery efficiency, and economic benefits of the 48-h short-stay pathway.

Methods

This retrospective study included 175 patients who underwent RAPN between February 2022 and June 2024. Patients were assigned to a 48-h short-stay group (n = 60) or a traditional inpatient group (n = 115). A 1:1 propensity score matching (PSM) was conducted to balance baseline characteristics, including age, sex, BMI, comorbidities, tumor features, surgeon identity, and surgical year. Perioperative outcomes, recovery indicators, complications, and medical costs were compared.

Results

After PSM, 53 matched pairs were analyzed. The short-stay group showed significantly shorter operative time, less intraoperative blood loss, shorter warm ischemia time, earlier mobilization, earlier oral intake, faster bowel function recovery, and shorter bed rest (all P < 0.05). The short-stay group had 71.7% of patients discharged on postoperative day (POD) 1 and 100% within 48 h, while the traditional group had 22.6% on POD1, 33.96% on POD2, and 43.4% on POD ≥ 3 (P < 0.001). Both total and postoperative hospital stays were significantly shorter in the short-stay group (2.00 vs. 6.00 days, P < 0.001), with lower hospitalization costs (P < 0.001). Postoperative creatinine was lower in the short-stay group (P = 0.023), while creatinine change was comparable (P = 0.063). Complication rates, emergency department visits, and 30-day readmission rates were similar between groups (all P > 0.05). The short-stay group had a significantly lower drain placement rate (P = 0.002) without increased adverse events.

Conclusion

The 48-h short-stay pathway for selected patients undergoing RAPN is feasible and safe. It accelerates postoperative recovery, shortens hospital stay, reduces medical costs, and optimizes healthcare resource utilization, without compromising safety or oncological early outcomes.