The evidence-based pathway for peri-operative management of open and robotically assisted laparoscopic radical prostatectomy

BJU Int. 2007 May;99(5):1103-8. doi: 10.1111/j.1464-410X.2007.06777.x. Epub 2007 Feb 19.

Abstract

Objective: To assess reports supporting the novel and comprehensive evidence-based pathway for radical prostatectomy (RP), as collaborative-care pathways have helped to optimize management of patients treated with RP and such clinical pathways provide an ideal framework for constructing an original evidence-based pathway for the complete peri-operative care of these patients.

Patients and methods: We searched for articles on Medline via PubMed to identify reports describing consensus opinions on appropriate aspects of the peri-operative management of patients treated with RP, specifically seeking to discern information on preoperative antibiotic regimen, peri-operative laboratory testing, use of beta-blockers for those at cardiac risk, pulmonary treatment, deep venous thrombosis prophylaxis, diet advancement, pain management, anti-emetic use, bowel regimen, and catheter removal after RP.

Results: Available reports were used to substantiate each variable of our collaborative-care pathway for RP. When available, meta-analyses were used to provide a broad review of the recognized clinical research. Otherwise, many controlled studies and retrospective reviews were relied upon to provide evidence to construct a framework for clinical decision-making.

Conclusions: This is the first pathway for the peri-operative management of major urological procedure that is well integrated into current literature. The critical aspects of clinical decision-making in the patient treated with RP were validated by the available research.

Publication types

  • Review
  • Validation Study

MeSH terms

  • Blood Loss, Surgical
  • Decision Making
  • Evidence-Based Medicine*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Postoperative Care / methods
  • Postoperative Complications / prevention & control
  • Prostatectomy / instrumentation*
  • Prostatectomy / methods
  • Prostatic Neoplasms / surgery*
  • Robotics*
  • Treatment Outcome