A Single Overnight Stay After Robotic Partial Nephrectomy Does Not Increase Complications.

To evaluate the feasibility of postoperative day 1 (POD1) discharge after robotic partial nephrectomy (RPN) and to determine whether a protocol targeting a shorter length of stay (LOS) is associated with any difference in the rate of postoperative complications. We reviewed a prospectively maintained, multi-institutional database of patients who underwent RPN from September 2013 to September 2016. Three of the six participating surgeons used a protocol that targeted discharge on POD1, whereas three surgeons did not. Patient characteristics and postoperative complication rates between the two groups were compared. A total of 665 patients were included, 455 of whom were treated by surgeons utilizing a POD1 discharge protocol, whereas 210 were not. The mean LOS for those in the POD1 protocol group was 1.13 days 2.02 days in the non-protocol group. Between groups, there were no differences in age ( = 0.098), body mass index ( = 0.164), tumor size ( = 0.502), or R.E.N.A.L. Nephrometry score ( = 0.974), but POD1 discharge protocol patients had higher age-adjusted Charlson comorbidity score (4 2,  = 0.033), were less likely to have a hilar tumor (15.9% 23.1%,  = 0.03), and had a larger percent decrease in discharge estimated glomerular filtration rate (-15.9% -7.1%,  < 0.001). There were no differences in the rates of overall ( = 0.715), major ( = 0.164), medical ( = 0.089), or surgical complications ( = 0.301) or in complications by the Clavien-Dindo category ( = 0.13). Discharge on POD1 after RPN is feasible, reproducible by different surgeons, and not associated with an increased risk of postoperative complications.