Putting Evidence to Practice in the Management of Patients Submitted to Radical Cystectomy: Outcomes from a National Survey
نویسندگان
1 Urology Department, Egas Moniz Hospital, Lisbon, Portugal
2 Urology Department, Portuguese Oncological Institute of Oporto Francisco Gentil, Oporto, Portugal
3 Urology Department, Portuguese Oncological Institute of Oporto Francisco Gentil, Oporto, Portugal
4 Urology Department, Portuguese Oncological Institute of Oporto Francisco Gentil, Oporto, Portugal
5 Urology Department, Portuguese Oncological Institute of Oporto Francisco Gentil, Oporto, Portugal
6 Urology Department, Vila Nova de Gaia / Espinho Hospital Centre, Vila Nova de Gaia, Portugal
7 Urology Department, Local Health Unit of Matosinhos, Pedro Hispano Hospital, Matosinhos, Portugal
8 Urology Department, Padre Américo Hospital, Penafiel, Portugal
9 Urology Department, Coimbra University Hospital Centre, Coimbra, Portugal
10 Urology Department, São José Hospital, Lisbon, Portugal
11 Urology Department, Egas Moniz Hospital, Lisbon, Portugal
12 Urology Department, Egas Moniz Hospital, Lisbon, Portugal
13 Urology Department, Egas Moniz Hospital, Lisbon, Portugal
14 Urology Department, Portuguese Oncological Institute of Oporto Francisco Gentil, Oporto, Portugal
15 Urology Department, Prof. Doutor Fernando Fonseca Hospital, Sintra, Portugal
16 Urology Department, Oporto university Hospital Centre, EPE, Oporto, Portugal
17 Urology Department, Cascais Hospital, Dr. José de Almeida, Cascais, Portugal
18 Urology Department, Beatriz Ângelo Hospital, Loures, Portugal
19 Urology Department, Santa Maria Hospital, Lisbon, Portugal
20 Urology Department, Santo André, Hospital, Leiria, Portugal
21 Urology Department, Cuf Tejo Hospital, Lisbon, Portugal
doi
10.22034/tru.2022.369260.1135چکیده
Introduction:Radical cystectomy (RC) is recognized as the standard gold treatment for patients with high-risk muscle-invasive bladder cancer (MIBC) and non-MIBC (NMIBC). Admission and adoption of early recovery protocols following RC (ERPRC) are highly variable throughout the world. We sought to examine current practice patterns and adherence to early improvement pathways in the perioperative management of RC through a survey administered to national urologists.Methods: We conducted a multicenter cross-sectional study through a survey that addressed different components of the ERPRC. Two authors (ABS and JNP) reviewed the available ERPRC evidence. The questionnaire included 24 questions. Participants provided consent, and their anonymity was assured.Results: Sixty-six responses were gathered from 17 centers. 64% of the respondents mentioned not having a formal ERPRC in their center. However, high-volume cases showed a significantly higher ERPRC implementation rate (51.5% vs. 10.5% vs. 0%, P-value<0.05). In the preoperative period, anemia correction and avoidance of bowel preparation were the most implemented steps. Intraoperatively, urologists tend to follow ERPRC recommendations in the postoperative period. No statistically significant differences were found in ERPRC components adopted in the perioperative period and the median length of hospital stay (9 days, P-value=0.09), irrespective of surgical center volume. ERPRC is agreed by 77% of urologists to be useful or very useful for achieving better outcomes.Conclusions: Although most of the urologists pointed out that ERPRC was not formally implemented at their center, most parts indicated that ERPRC significantly improved outcomes during RC PO and, therefore, were followed.
