Reducing unnecessary blood tests after robot assisted prostate surgery

This study evaluated the safety of eliminating routine postoperative blood tests after conducting robot-assisted radical prostatectomy (RARP) in patients with localized prostate cancer (PCa) and proposed recommendations for their use. 

Localized prostate cancer (PCa) refers to cancer that is confined to the prostate gland. RARP involves the use of robotic surgical instruments that assist surgeons to remove the prostate and surrounding tissues in a precise manner. The technique produces fewer complications compared to open and laparoscopic (keyhole) surgeries. RARP also reduces blood loss during surgery and its effectiveness is similar to open and laparoscopic options. 

Currently, there are no national or international guidelines outlining whether routine postoperative blood tests are required after RARP. 

The study included a total of 1340 patients with localized PCa who received RARP. Of these, 300 patients had new recommendations to avoid routine postoperative blood tests. The average follow-up period was 90 days for patients. 

Overall, 72% of patients had routine postoperative blood tests without any accompanying complications or clinical concerns. 6% of patients had a discharge delay of at least 1 day.

Implementation of the recommendations led to a 73% reduction in blood tests after RARP. There was also a decrease in routine postoperative blood tests requests from 100% to 27%. The new recommendations resulted in discharge delays due to unnecessary blood tests from 6% to 0%.

99.9% of all complications could be diagnosed by clinical assessments during and after RARP compared to 43% by routine postoperative blood tests alone.

The study indicated that unless there is a specific clinical indication to perform routine postoperative blood tests, such as in patients likely to experience side effects, they are not necessary after RARP.

Data was collected from only two health centers. Larger studies are needed to confirm these results.