Safety and effectiveness of robot-assisted partial nephrectomy in ambulatory mode: a single-center retrospective cohort study.

To compare short-term outcomes and resource use between ambulatory and conventional inpatient robot-assisted partial nephrectomy (RAPN). This single-center retrospective cohort included 143 consecutive adults with localized renal tumors who underwent RAPN from June 2021 to December 2024. The ambulatory group (n = 75) followed a standardized pathway with planned discharge within 48 h and structured post-discharge nursing follow-up; the conventional inpatient group comprised 68 patients. Perioperative recovery, hospital resource use, renal function, and 30-day safety outcomes were compared. Baseline, tumor, operative, and renal-function measures did not differ significantly between groups. The ambulatory group had shorter drainage-tube duration, earlier ambulation, oral intake, catheter removal, and return to normal activity, shorter hospital stay [29.0 (27.5-30.5) vs. 87.5 (80.8-99.0) h], and lower hospitalization cost [45,860 (44,876 - 46,806) vs. 62,096 (60,452 - 63,862) CNY] (all P < 0.001). Planned discharge was completed by 67 of 75 ambulatory patients (89.3%); 8 (10.7%) had delayed discharge. No statistically significant between-group differences were detected in transfusion, positive margins, readmission, reoperation, 30-day complications, wound infection, or eGFR through 3 months. The ambulatory group had more follow-up calls and messages within 7 days (both P < 0.001). In selected patients at an experienced center, ambulatory RAPN was associated with shorter hospitalization, lower in-hospital cost, and earlier recovery without a statistically detectable increase in short-term adverse outcomes. The retrospective single-center design and low event counts preclude causal or equivalence conclusions.