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Titolo:
SAME-DAY SURGERY FOR RADICAL RETROPUBIC PROSTATECTOMY - IS IT AN ATTAINABLE GOAL
Autore:
PALMER JS; WORWAG EM; CONRAD WG; BLITZ BE; CHODAK GW;
Indirizzi:
WEISS MEM HOSP,PROSTATE & UROL CTR,4646 N MARINE DR CHICAGO IL 60640 UNIV CHICAGO,DEPT SURG,UROL SECT CHICAGO IL 60637 UNIV CHICAGO,DEPT ANESTHESIA & CRIT CARE CHICAGO IL 60637 PRITZKER SCH MED CHICAGO IL 00000
Titolo Testata:
Urology
fascicolo: 1, volume: 47, anno: 1996,
pagine: 23 - 28
SICI:
0090-4295(1996)47:1<23:SSFRRP>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTRAOPERATIVE AUTO-TRANSFUSION; NEUROPATHIC PAIN BEHAVIOR; THROMBOEMBOLIC COMPLICATIONS; POSTOPERATIVE PAIN; EPIDURAL MORPHINE; INJURY DISCHARGE; ANALGESIA; RATS; BUPIVACAINE; CARCINOMA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
34
Recensione:
Indirizzi per estratti:
Citazione:
J.S. Palmer et al., "SAME-DAY SURGERY FOR RADICAL RETROPUBIC PROSTATECTOMY - IS IT AN ATTAINABLE GOAL", Urology, 47(1), 1996, pp. 23-28

Abstract

Objectives. Economic forces are stimulating a re-evaluation of various management strategies. Recent critical pathways for radical prostatectomy have resulted in reduced length of stay to as low as 2.9 days. Methods. The time in the operating room and recovery room, average blood loss, length of hospitalization, patient charges, and estimated hospital costs were compared for 20 patients undergoing radical prostatectomy up to 1 year before and for 27 men after initiation of a critical pathway. Under the protocol, patients receive an education booklet andpreoperative teaching in preparation for early discharge and an epidural for anesthesia. An anonymous questionnaire was mailed to all patients treated by the pathway after catheter removal. Results. The new pathway resulted in a significant reduction in average time in the operating room (3.7 +/- 0.4 hours versus 4.9 +/- 1.2 hours), estimated blood loss (1204 +/- 527 cc versus 1948 +/- 740 cc), and length of hospitalization (1.7 +/- 0.6 days versus 4.6 +/- 1.5 days). In addition, patient charges and hospital costs were reduced by 32% and 35%, respectively. Thirty-seven percent of the study group was discharged after 1 night compared with 0% in the group treated before the pathway was initiated. Forty-one percent of the study group was not transfused and did not donate blood. Outcome surveys completed by 25 of 27 study patients revealed an overall satisfaction of 96% with 0 of 10 patients who weredischarged after one night indicating they would have preferred to behospitalized longer. Conclusions. Conventional management of men undergoing radical prostatectomy can be safely modified while preserving patient satisfaction without increasing morbidity. Avoiding peripheral narcotics and emphasizing preoperative teaching has enabled us to reduce length of stay greatly, with same day discharge now an attainable goal.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/04/20 alle ore 22:59:12