Outpatient Radical Prostatectomy - Surgical and Anesthetic Considerations
Condition: Prostatic Neoplasms
MeSH terms: Prostatic Neoplasms
Study type: Interventional

Summary: 
      Radical prostatectomy has become the gold standard treatment for prostate cancer.

      Regarding of morbidity of access on open retropubic radical prostatectomy a lot of centers
      around the world start to develop laparoscopic and robotic approach over the past years. The
      problems regarding this techniques is that the pure laparoscopic prostatectomy shows a steep
      learning curve with a high initial complication rate, and the use of robotic assistance
      surgery despite of lower learning curve is associated with higher surgical supply and
      operative room costs. These costs may have a significant impact on overall cost of prostate
      cancer care especially in Brazil.

      In Brazil, the open route for radical prostatectomy is still the most frequent approach. One
      of the disadvantages of open prostatectomy from the other surgeries is the longest hospital
      stay. However, the question of what length of stay after this operation is optimal and
      necessary is unresolved. In this trial the investigators have compared a randomized group of
      patients that had discharged on postoperative day 2, 1 and same day surgery. The
      investigators had intent to evaluate the feasibility of ambulatory open radical prostatectomy
      (patient discharge in the same day of surgery - average 12 hours of hospitalization)
      maintaining patient satisfaction and safety.
    

Detailed description: 
      Radical prostatectomy initially described by Walsh (1982) has become the gold standard
      treatment for prostate cancer and has evolved enormously over the last 25 years. Improvements
      include the use of smaller incisions, reduced blood loss, shorter hospital stays, and
      surgical refinement. Several large series with long-term follow-up have confirmed that this
      approach results in excellent cancer control and functional results in terms of preservation
      of erectile potency and urinary continence.

      Regarding of morbidity of access on open retropubic radical prostatectomy a lot of centers
      around the world start to develop laparoscopic and robotic approach over the past years. The
      problems regarding this techniques is that the pure laparoscopic prostatectomy shows a steep
      learning curve with a high initial complication rate, and the use of robotic assistance
      surgery despite of lower learning curve is associated with higher surgical supply and
      operative room costs. These costs may have a significant impact on overall cost of prostate
      cancer care especially in Brazil where nowadays only have 3 centers with 5 robots.

      In Brazil, the open route for radical prostatectomy is still the most frequent approach,
      mainly out of large cities. One of the disadvantages of open prostatectomy from minimally
      invasive surgeries is the longest hospital stay. However, the question of what length of stay
      after this operation is optimal and necessary is unresolved. In this trial the investigators
      have compared a randomized group of patients that had discharged on postoperative day 2, 1
      and same day surgery. The investigators had intent to evaluate the feasibility of ambulatory
      open radical prostatectomy (patient discharge in the same day of surgery - average 12 hours
      of hospitalization) while maintaining patient satisfaction and safety.
    

Intervention name(s): patient discharge on postoperative day 2; patient discharge on postoperative day 1; patient discharge in the day of surgery
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): The patient was discharge on postoperative day 2 (as was done routinely); The patient was discharge on postoperative day 1; The patient was discharge in the evening of the same day of surgery (average 12 hours of hospitalization)
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Prostatic Neoplasms; Prostatectomy, Retropubic; Patient Discharge