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Predictive factors of postoperative complications and hospital readmission after implementation of the single‐port robotic platform: A single‐center and single‐surgeon experience
Author(s) -
Lenfant Louis,
Aminsharifi Alireza,
Kim Soodong,
Kaouk Jihad
Publication year - 2021
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.14503
Subject(s) - medicine , surgery , perioperative , single center , complication , cohort , port (circuit theory) , logistic regression , retrospective cohort study , body mass index , urinary system , incidence (geometry) , physics , electrical engineering , optics , engineering
Objectives To measure the incidence, and identify potential risk factors of conversion, postoperative complication and readmission for patients treated with urological robotic single‐port surgery. Methods All consecutive urological surgery procedures carried out with the single‐port robotic platform by the same surgeon in a single institution between September 2018 and March 2020 were included in this retrospective analysis. Demographic data, main perioperative outcomes and information related to the surgical technique were gathered and analyzed. A logistic regression model was used to assess predictive factors for any grade and high‐grade (e.g. Clavien grade ≥3) postoperative complications, as well as predictive factors for readmission. Results Analysis included 221 patients, of whom 194 (88%) underwent pelvic surgery and 27 (12.2%) underwent upper urinary tract surgery. Only one patient was converted to open surgery in the entire cohort. A total of 40 patients (18.1%) experienced postoperative complications, with grade ≥3 postoperative complications in 7.6% of the entire cohort. On multivariable analysis, the factors significantly associated with the risk of postoperative complication of any grade were diabetes ( P < 0.001), perineal approach ( P < 0.01) and postoperative pain management with opioids ( P = 0.01). Only diabetes ( P = 0.03) predicted a grade ≥3 complication. Overall, 17 patients (7.7%) were readmitted during the 3 months after surgery. A body mass index >30 kg/m 2 was the only identified predictor of readmission ( P = 0.01). Conclusion A wide range of pelvic, extraperitoneal and upper‐tract urological procedures can be carried out using the robotic single‐port platform with a minimal conversion rate and low complication or readmission rate.