For a study, researchers sought to compare the effectiveness and safety of same-day (SDD) vs. standard-length discharge (SLD) transurethral resection (TURP), holmium laser enucleation (HoLEP), and GreenLight photovaporization (GL-PVP) of the prostate procedures.
The yearly proportion of TURP, HoLEP, and GL-PVP procedures conducted with SDD (length of stay [LOS] = 0 days) was computed using the 2015-2019 ACS-NSQIP files. Patients were divided into SDD and SLD groups according to their length of stay (LOS) (TURP: LOS = 1-3 days, HoLEP and GL-PVP: LOS = 1-2 days); patients with prolonged LOS were omitted. Age, body mass index, American Society of Anesthesiologists score, and modified Charlson Comorbidity Index score were used to match patients 1:1 by age. In order to examine 30-day unplanned readmissions, reoperations, and Clavien-Dindo (CD) complications between SLD and SDD, they used logistic regression to assess predictors of unfavorable outcomes.
Compared to a small percentage of TURP and HoLEP patients, the majority of GL-PVP patients underwent SDD. For HoLEP, TURP, and GL-PVP, respectively, SDD use grew, stayed constant, and decreased with time. Rates of reoperation, CD I/II, or CD IV complications for the 46,898 included patients (31,872 TURP, 2,901 HoLEP, 12,125 GL-PVP) were comparable before and after matching. Following TURP (3.48% vs. 4.25%, P=.013) and HoLEP (1.93% vs. 4.43%, P=.003), 30-day unplanned readmission rates for matched SDD patients were comparatively lower. SLD was associated with unplanned readmission following TURP and HoLEP on multivariate analysis for both mismatched and matched populations.
SDD following TURP, HoLEP, & GL-PVP did not increase the risk of 30-day problems for adequately chosen patients, indicating that patient selection for SDD is carried out safely across the country.
Reference: goldjournal.net/article/S0090-4295(22)00095-4/fulltext
