Risk factors for delayed discharge following early discharged robot-assisted laparoscopic radical prostatectomy

Background: Prostate cancer is one of the most common malignancies among men worldwide, and its incidence in China has been increasing rapidly. Robot-assisted laparoscopic radical prostatectomy (RARP) has become the standard surgical approach for localized prostate cancer due to its high precision and minimally invasive advantages. With the growing implementation of enhanced recovery after surgery (ERAS) protocols, early discharged surgical models have been introduced in urology to shorten hospital stays and improve patient satisfaction. However, some patients experience delayed discharge, limiting the wider adoption of early discharged RARP. This study aimed to identify the factors associated with delayed discharge in patients undergoing early discharged RARP. Methods: A retrospective analysis was conducted on 57 patients with localized prostate cancer who underwent RARP performed by a single surgeon between January 2023 and October 2024. Patients were divided into two groups according to whether they were discharged as scheduled (early discharged group) or had delayed discharge. Perioperative and clinical data were analyzed to determine the factors associated with delayed discharge. Results: Of the 57 patients, 35 (61.4%) were discharged as scheduled, and 22 (38.6%) experienced delayed discharges. Extended postoperative fasting time, delayed drain removal, and surgeries ending after 20:00 were significant predictors of delayed discharge (p < 0.05). Other factors, such as operative time, intraoperative blood loss, surgical approach, postoperative pain score, postoperative inflammatory markers, and pathological findings showed no significant association (p > 0.05). Conclusions: Prolonged fasting, delayed drain removal, and late surgical completion are key factors associated with delayed discharge after early discharged RARP. Optimizing perioperative management—including early feeding, timely drain removal, and proper scheduling—can enhance recovery and promote the safe implementation of early discharged RARP.

Prostate cancer; Robot-assisted surgery; Early discharged surgery; Delayed discharge; Enhanced recovery after surgery

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