Next-day discharge after minimally invasive partial nephrectomy: an analysis of the US National Surgical Quality Improvement Program

Abstract

Next-day discharge in select patients after minimally invasive partial nephrectomy is effectively being utilized by a large, nationwide cohort of surgeons. This approach is feasible in certain patient populations though further research must determine selection criteria for safe next-day discharge.

Application of Contrast-Enhanced Ultrasonography (CEUS) in the Assessment of Kidney Wound Recovery After Nephron-Sparing Surgery

“…score ≤9) in these studies. [7][8][9] However, it was unknown that whether ERAS protocol was suitable for patients with large or complex masses, and to date, there have been no prospective studies that have determined which perioperational factors allowed early discharge. 8 Kidney wound healing which was one of the critical factors associated with the recovery of NSS may be crucial for early discharge, and the morphological evidence of kidney wound healing was lacking.…”

“…[7][8][9] However, it was unknown that whether ERAS protocol was suitable for patients with large or complex masses, and to date, there have been no prospective studies that have determined which perioperational factors allowed early discharge. 8 Kidney wound healing which was one of the critical factors associated with the recovery of NSS may be crucial for early discharge, and the morphological evidence of kidney wound healing was lacking. Gregory et al 22 checked the leakage from partial nephrectomy defects by injecting indigo carmine into the renal arteries of porcine kidneys to compare the suture effect, which showed leakage or not of vascular contents could reflect the state of wound recovery.…”

“…underwent serial CEUS at short time intervals (1,3,8,15,30,60, 90 and 180 days post-trauma) until splenic trauma became no more visible. But no change in injury was observed within three days post-trauma, and CEUS was applied to diagnose delay active hemorrhage or assess healing time of solid organ injuries in these studies.…”

“… 7–9 However, it was unknown that whether ERAS protocol was suitable for patients with large or complex masses, and to date, there have been no prospective studies that have determined which perioperational factors allowed early discharge. 8 …”

“…6 Furthermore, in several centers, postoperative day 1 (POD1) discharge protocols without an increase in post-discharge complications were successfully utilized for many patients after minimally invasive nephron-sparing surgery (MINSS). [7][8][9] But the critical factor associated with the recovery of NSS such as kidney wound healing was mostly unexplored. Although multidetector CT is applied to diagnose the complications about kidney wound such as hemorrhage and urine leaks, 10,11 the continuous observation of kidney wound in the early postoperative stage of NSS has not been reported, so we aimed at seeking for an image examination method to reflect the process of kidney wound healing.…”