Induction of Clinical Pathways in Portless Endoscopic Urological Surgery for Prostate Cancer

Abstract

【Purpose】Prostate cancer is a commonly diagnosed malignancy in men. Radical prostatectomy is an effective treatment for clinically localized carcinoma of the prostate. Clinical pathways were implemented to standardize the therapy (prostatectomy) of prostate cancer. We evaluated the usefulness of the clinical pathway for portless endoscopic urological surgery in prostate cancer.

【Method】The subjects were 20 patients undergoing radical prostatectomy. The time periods of medical treatment such as the first meals after surgery, removal of the urethral catheter and postoperative admission days were standardized. The patients answered a questionnaire that stated their degree of satisfaction.

【Results】Using this clinical pathway, 90% of the patients could begin eating and walking 2 days after surgery. 85% of the patients had their urethral catheters removed within 7 days after the operation. 85% of the patients were discharged ten days after the operation. 3 patients needed to stay in the hospital longer because of urinary retention, surgical site infection, or insufficient anastomosis of the bladder neck. Surgical site infection occurred in 1 prostatectomy case (5%). Urinary continence, which was defined as wearing no pads, gradually improved during the first month after surgery, and at 3 months, 88.9% of the patients were dry. ln this study, more than 90% of the patients were satisfied with the operation and hospital stay.

【Conclusion】The clinical pathway is considered to be a good tool for giving higher quality and better service to patients. We recognized the importance of deciding the outcome such as the first meal after surgery, postoperative admission days and the removal of the urethral catheter when developing the clinical pathway.