Feasibility and Safety of Same-say Discharge after Robot-assisted Radical Prostatectomy: A Systematic Review and Meta-analysis.

BACKGROUND AND

OBJECTIVE

Same-day discharge (SDD) after robot-assisted radical prostatectomy (RARP) is increasingly adopted as a standard of care. This systematic review and meta-analysis assess the safety and effectiveness of SDD compared with conventional inpatient (IP) management.

METHODS

A literature search was conducted in accordance with PRISMA guidelines using PubMed/MEDLINE, Embase, Web of Science, and Scopus databases up to February 2025, including only comparative studies reporting on SDD versus IP RARP. The primary endpoint was postoperative complication rates. Secondary endpoints included 30-day readmission rates, unplanned postoperative visits, and patient-reported satisfaction. Subgroup analysis focused on studies involving single-port (SP) robotic platforms.

KEY FINDINGS AND LIMITATIONS: Nineteen studies were included, encompassing 11 211 SDD and 114 999 IP cases. Overall complication rates were lower in the SDD group (odds ratio [OR]: 0.65, 95% confidence intervals [CI]: 0.50-0.84, p < 0.001). The pooled OR favored the outpatient group for both minor and major complications (OR: 0.52, 95% CI: 0.28-0.98, p = 0.042). No significant differences were found in 30-d readmissions (OR: 0.89, 95% CI: 0.77-1.02, p = 0.082), unplanned visits (odds OR: 0.61, 95% CI: 0.35-1.07, p = 0.081), or continence recovery. In the SP subgroup, no differences were observed in major complications (OR: 0.71, 95% CI: 0.39-1.29; p = 0.7) or readmission rates (OR: 1.88, 95% CI: 0.56-6.39, p = 0.3). The main limitation was the retrospective design of most studies.

CONCLUSIONS AND CLINICAL IMPLICATIONS: The available evidence does not allow reliable causal comparisons between SDD and inpatient care after RARP; however, perioperative outcomes within SDD cohorts appear acceptable, supporting the feasibility of SDD in carefully selected patients.