Fast track program in patients undergoing radical cystectomy: results in 362 consecutive patients

Journal of the American College of Surgeons
Raj S PruthiEric M Wallen

Abstract

This article outlines our current perioperative management of patients undergoing cystectomy and urinary diversion using advancements in perioperative care to allow for early institution of an oral diet and early hospital discharge. Three hundred sixty-two consecutive patients underwent radical cystectomy and urinary diversion with curative intent (2001 through 2008). Each underwent a perioperative care plan ("fast track" program). Throughout our experience, evidence-based modifications to this program were instituted. We analyzed the impact of these modifications and report the outcomes with the most recent 100 patients in whom no additional modification has been used. Mean age of patients is 66.3 years, with 44% of the patients older than age 70 years and 12% older than age 80 years. We found no detrimental effects to immediate removal of the orogastric tube at the end of the procedure, but found a beneficial effect of empiric metoclopramide use, with lower rates of nausea and vomiting. Perioperative antibiotic coverage has been reduced to 24 hours as per American Urological Association guidelines. Gum-chewing has also been shown to be of benefit with regard to a more rapid recovery of bowel function. Use of nonnarcotic analg...Continue Reading

References

Jul 13, 2002·Journal of the American College of Surgeons·Takayuki AsaoMunenori Ide
Nov 13, 2007·The Journal of Urology·M Craig HallPaul F Schellhammer
Feb 13, 2008·World Journal of Surgery·Daniel K Sokol, James Wilson
Feb 19, 2008·The Journal of Urology·J Stuart WolfUNKNOWN Urologic Surgery Antimicrobial Prophylaxis Best Practice Policy Panel
Feb 26, 2008·Langenbeck's Archives of Surgery·Ulrich RonellenfitschMatthias Schwarzbach
Jul 25, 2008·Annals of Surgery·Henrik Kehlet, Douglas W Wilmore

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Citations

Jul 30, 2011·Der Urologe. Ausg. A·A KarlC Stief
Dec 25, 2013·Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie·E DrapierA Smirnoff
Mar 8, 2013·Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society·Olivia HerdimanNathan Lawrentschuk
Sep 29, 2011·Annals of the Royal College of Surgeons of England·Bruce Campbell, John S McGrath
Aug 3, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jin Chen HuZhong Chuan Lv
Jul 16, 2014·Nature Reviews. Urology·Julian SmithJohn McGrath
Aug 5, 2014·Current Problems in Cancer·Jong Chul ParkAndrea B Apolo
Jul 12, 2011·Journal of Endourology·Asha D Shah, Ronney Abaza
Dec 20, 2015·The Journal of Urology·Naveen KrishnanBruce L Jacobs
Feb 11, 2015·Scandinavian Journal of Urology·Beata PerssonOlle Ljungqvist
Feb 4, 2014·Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie·C PfisterUNKNOWN Les membres du CCAFU
Jan 8, 2013·European Urology·Mathew C Raynor, Raj S Pruthi
Aug 28, 2015·Journal of Surgical Oncology·Raj Kurpad, Michael Woods
Jun 7, 2011·Journal of the American College of Surgeons·Cheryl Chia-Hui ChenSharon K Inouye
Mar 23, 2011·The Journal of Urology·Benjamin M WhittamRandall G Rowland
Sep 19, 2015·Urology·Richard S MatulewiczJoshua J Meeks
Jul 6, 2015·Actas urologicas españolas·S M Ortega-LuceaA M Pascual-Bellosta
Jan 1, 2015·Bladder Cancer·Zach HamiltonEugene K Lee
Apr 29, 2015·Current Urology Reports·Gregory M JandaRaj S Pruthi
Mar 17, 2015·Current Urology Reports·Jeffrey J Tomaszewski, Marc C Smaldone
Feb 19, 2015·Current Urology Reports·Marie C HupeAxel S Merseburger
Feb 13, 2014·The Journal of Urology·Siamak DaneshmandHooman Djaladat
Apr 30, 2016·Current Urology Reports·Hooman Djaladat, Siamak Daneshmand
Jul 5, 2016·European Urology·J Alfred WitjesMaria J Ribal
Sep 21, 2016·Chinese Medical Journal·Xin-Xin LiuJie-Shou Li
Sep 25, 2017·Journal of Surgical Oncology·Daniel Zainfeld, Hooman Djaladat

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