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根治性前列腺切除术后的术后实践评估及出院建议

Assessment of postoperative practices and discharge recommendations after radical prostatectomy.

作者信息

Melão Bárbara Vieira Lima Aguiar, Assel Melissa, Pere Maria, Nalavenkata Sunny, Touijer Karim A, Laudone Vincent P, Lin Daniel W, Rivas Juan Gomez, Bjartell Anders, Carlsson Sigrid V

机构信息

Department of Urology, University of São Paulo, São Paulo, Brazil.

Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY.

出版信息

Urol Oncol. 2025 Aug;43(8):471.e9-471.e16. doi: 10.1016/j.urolonc.2025.03.027. Epub 2025 Apr 29.

Abstract

PURPOSE

Consistent, accurate postoperative guidance is crucial for early recovery and patient satisfaction in urology, especially for radical prostatectomy (RP) patients. However, patients often receive inconsistent information, highlighting the need for standardized, evidence-based postoperative care guidelines.

MATERIALS AND METHODS

We conducted a comprehensive review and evaluation of current postoperative practices for RP. This involved (1) reviewing existing discharge information at Josie Robertson Surgery Center, Memorial Sloan Kettering Cancer Center to identify areas of improvement; (2) systematically evaluating inconsistencies in discharge instructions and their impact on patient care; (3) distributing an anonymous survey to urologists in the US and Europe via REDCap to gather insights into global postoperative care practices. The survey included questions on various aspects of postoperative care, such as catheter use, medication regimens, dietary restrictions, and physical activity guidelines.

RESULTS

We received 247 survey responses. Despite some consensus on certain postoperative practices and recommendations, significant variability existed, underscoring the lack of standardized guidelines. Notable differences were observed between US and European cohorts, particularly in postoperative length of stay and discharge practices. Only 1.4% of US responders discharged patients 3 or more days postsurgery compared to 46% in Europe. Variability was also noted in recommendations for erectile function medications and postoperative activity restrictions.

CONCLUSION

This study underscores the significant variability in postoperative care recommendations for RP and the urgent need for standardized, evidence-based guidelines. Implementing such guidelines will enhance patient recovery, satisfaction, and overall outcomes, improving postoperative care across various surgical procedures.

摘要

目的

持续、准确的术后指导对于泌尿外科患者的早期康复和满意度至关重要,尤其是对于根治性前列腺切除术(RP)患者。然而,患者常常收到不一致的信息,这凸显了制定标准化、基于证据的术后护理指南的必要性。

材料与方法

我们对当前RP术后实践进行了全面回顾和评估。这包括(1)审查纪念斯隆凯特琳癌症中心乔西·罗伯逊手术中心现有的出院信息,以确定改进领域;(2)系统评估出院指导中的不一致之处及其对患者护理的影响;(3)通过REDCap向美国和欧洲的泌尿外科医生发放匿名调查问卷,以深入了解全球术后护理实践。该调查包括关于术后护理各个方面的问题,如导尿管使用、药物治疗方案、饮食限制和身体活动指南。

结果

我们收到了247份调查问卷回复。尽管在某些术后实践和建议上存在一些共识,但仍存在显著差异,这突出了缺乏标准化指南的问题。在美国和欧洲队列之间观察到显著差异,特别是在术后住院时间和出院实践方面。美国只有1.4%的受访者在术后3天或更长时间让患者出院,而欧洲这一比例为46%。在勃起功能药物推荐和术后活动限制方面也存在差异。

结论

本研究强调了RP术后护理建议存在显著差异,以及迫切需要标准化、基于证据的指南。实施此类指南将提高患者的康复效果、满意度和总体结果,改善各种手术程序的术后护理。

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