부산대학교 도서관

Objective To determine the success of our clinical care pathway for laparoscopic ( LPN) and robotic partial nephrectomy ( RPN) and to examine factors predictive for success., Patients and Methods A retrospective review of our Institutional Review Board-approved prospectively maintained minimally invasive PN database yielded 263 consecutive minimally invasive PNs from 2003 to 2010., Patient, disease and surgery-related factors were collected. The primary endpoint was successful implementation of the clinical pathway with discharge on postoperative day ( POD 1)., Associated factors were modelled using univariate and multivariable logistic regression to determine factors predictive for success of the pathway., Results Overall, 157 (60%) of the patients had successful care pathway implementation with POD1 discharge, of which 46 (17%) were RPNs., The overall readmission rate was 5% (12/263) and similar for patients discharged on POD 1, 4.5% (7/157)., Several patient-related, tumour-related, and surgical factors were associated with care pathway success., In a multiple logistic regression model, only surgery period (late cohort vs early cohort) was significant for successful pathway implementation (odds ratio 4.2; 95% confidence interval 2.1-8.4, P < 0.001)., Conclusions Early discharge care pathways can be successfully implemented for LPN or RPN with low readmission rates. Care pathway success improves with institutional experience. [ABSTRACT FROM AUTHOR]