1853 A STANDARDIZED PERIOPERATIVE CARE PLAN DECREASES LENGTH OF STAY IN PATIENTS UNDERGOING ROBOTIC PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyKidney Cancer: Localized1 Apr 20111853 A STANDARDIZED PERIOPERATIVE CARE PLAN DECREASES LENGTH OF STAY IN PATIENTS UNDERGOING ROBOTIC PARTIAL NEPHRECTOMY Kenneth Jacobsohn, Peter Langenstroer, Mark Waples, and William See Kenneth JacobsohnKenneth Jacobsohn Milwaukee, WI More articles by this author , Peter LangenstroerPeter Langenstroer Milwaukee, WI More articles by this author , Mark WaplesMark Waples Milwaukee, WI More articles by this author , and William SeeWilliam See Milwaukee, WI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1900AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Robotic-assisted partial nephrectomy (RPN) is gaining acceptance and being performed with increasing volume for small renal masses. There are no widely-accepted perioperative management guidelines for these patients. In January 2010 we implemented a perioperative care plan for our RPN patients with the goal of standardizing and improving their outcomes. METHODS Following IRB approval we retrospectively reviewed the charts of all patients undergoing RPN by a single surgeon at our facilities from August 2008 until September 2010 and was performed using a 3 or 4 arm approach with the daVinci Surgical System (Intuitive Surgical, Sunnyvale, CA). Our perioperative care plan was implemented in January 2010 and consisted of preoperative counseling, pathway orders, oral analgesia, and early ambulation. RESULTS 71 patients underwent RPN at our institution, 48 prior to implementation of the plan and 23 after. Mean length of stay (LOS) was 2.9 days prior to implementation of the care plan and 1.4 days after (p=0.0002). 79% of patients were discharged on post operative day #1 following the implementation of the plan compared to 12.5% prior. There was no difference in complication, readmission or emergency room visit rates. Patient age, BMI, mean tumor size and warm ischemia time were 58 years, 30.1, 3.2cm and 17 minutes, and there was no statistically significant difference between the two groups. CONCLUSIONS Implementation of a perioperative care plan results in a significantly decreased LOS for patients undergoing RPN without impacting complication rates. Multi-institution studies of this care plan are needed to confirm its efficacy. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e743 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kenneth Jacobsohn Milwaukee, WI More articles by this author Peter Langenstroer Milwaukee, WI More articles by this author Mark Waples Milwaukee, WI More articles by this author William See Milwaukee, WI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...