N D Fischer1, S Epple2, E Wittenmeier3, U Betz4, A Haferkamp2, W Jäger2. 1. Klinik und Poliklinik für Urologie und Kinderurologie der Universitätsmedizin, Johannes-Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland. nikita.fischer@unimedizin-mainz.de. 2. Klinik und Poliklinik für Urologie und Kinderurologie der Universitätsmedizin, Johannes-Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland. 3. Klinik für Anästhesiologie und Intensivmedizin der Universitätsmedizin, Johannes-Gutenberg-Universität Mainz, Mainz, Deutschland. 4. Institut für Physikalische Therapie, Prävention und Rehabilitation der Universitätsmedizin, Johannes-Gutenberg-Universität Mainz, Mainz, Deutschland.
Abstract
BACKGROUND: In surgical fields there has been a perceivable paradigm shift during the last decade concerning patient pre- and rehabilitation. Current literature suggests close interdisciplinary collaboration after complex procedures such as radical cystectomy in order to optimize perioperative patient care for the benefit of "fast-track" surgery. OBJECTIVES: To compose a catalogue of standardized measures after radical cystectomy based on guidelines set by the ERAS®-Society. RESULTS: The protocol commences with preoperative education in order to improve the physical and psychological condition of the patient. Crucial aspects in peri- and postoperative patient care are gentle surgical technique, adequate pain management, early mobilization and oral food intake, early removal of drains and foreign material and a seamless return to normal, daily life. CONCLUSIONS: Prospective data analysis will be the next step in order to establish the effectiveness of the protocol especially regarding postoperative complications and median duration of hospital stay.
BACKGROUND: In surgical fields there has been a perceivable paradigm shift during the last decade concerning patient pre- and rehabilitation. Current literature suggests close interdisciplinary collaboration after complex procedures such as radical cystectomy in order to optimize perioperative patient care for the benefit of "fast-track" surgery. OBJECTIVES: To compose a catalogue of standardized measures after radical cystectomy based on guidelines set by the ERAS®-Society. RESULTS: The protocol commences with preoperative education in order to improve the physical and psychological condition of the patient. Crucial aspects in peri- and postoperative patient care are gentle surgical technique, adequate pain management, early mobilization and oral food intake, early removal of drains and foreign material and a seamless return to normal, daily life. CONCLUSIONS: Prospective data analysis will be the next step in order to establish the effectiveness of the protocol especially regarding postoperative complications and median duration of hospital stay.
Authors: Stavros K Kakkos; Joseph A Caprini; George Geroulakos; Andrew N Nicolaides; Gerard Stansby; Daniel J Reddy; Ioannis Ntouvas Journal: Cochrane Database Syst Rev Date: 2016-09-07