Poster Session 1: Oncology – Prostate (Part 1)

Introduction: Same-day discharge (SDD) after robot-assisted radical prostatectomy (RARP) has been shown to be feasible and safe in centers outside of Canada; however, heterogeneity exists in the inclusion criteria for those offered SDD in published literature.Our objective was to determine patient-specific and intraoperative predictors for failure of SDD for patients undergoing RARP at a Canadian center.Methods: A retrospective review was conducted of patients undergoing RARP at a Canadian tertiary academic center from May 2021 to May 2023.Multivariate regression analysis determined predictors for non-initiation and failure of SDD (GraphPad Prism, Boston, MA, U.S.).Results: We identified 387 patients, of whom 201 (51.9 %) were initiated on the SDD pathway.Of those initiated, 104 (51.7 %) were successfully discharged home the same day.Patients who traveled distances >100 km or who had obstructive sleep apnea (OSA) were significantly less likely to be initiated on the SDD pathway (Table 1).No association existed between patient body mass index ≥30 kg/m2, age ≥65, American Anesthesia Society (ASA) score ≥3, or case order on being initiated on the pathway (all p>0.05).Of those initiated on the SDD pathway, cases that were scheduled to be second or later, had an estimated blood loss ≥300 mL, or had a postoperative abdominal drain resulted in an increased likelihood of failing SDD after initiation.Operative time and ASA ≥3 had no significant relationship with failing SDD (all p>0.05).Conclusions: We found that patients who live a greater distance from the hospital or who have a medical history of OSA are predictive of not being initiated on the SDD pathway.Of those initiated, postoperative abdominal drains, increased intraoperative blood loss, or being the second/third case of the day are more likely to fail SDD.The results of this study inform potential inclusion and exclusion criteria for SDD pathways being developed in Canada.