Fast-track surgery in laparoscopic radical prostatectomy: basic principles.
Fast-track surgery describes innovative treatment concepts ensuring a faster convalescence phase. The aim of this study was to allow hospital discharge 3 days after surgery without additional complications in patients receiving LRPE for localized prostate cancer. Twenty-five patients each were randomized in the study groups to verify if a fast-track regimen could be transferred into clinical routine. The perioperative data, early complications, hospital stay as well as readmission rate were analyzed. The mean postoperative stay was 3.6 days in the fast-track group versus 6.7 days in the conventional group. The overall complications were significantly less in the fast-track procedure. The readmission rate was low and not significant. Patients receiving an LRPE benefit from a suitable fast-track concept. The postoperative hospital stay could be shortened nearly by half with a significantly decreased overall complication rate. Thus, fast-track concepts might contribute to saving resources in the long term. However, more evidence based on larger prospective trials is needed to achieve optimal quality of life for patients perioperatively.
Gralla
O
O
Department of Urology, Campus Mitte, Charité-Universitätsmedizin Berlin, Schumannstrasse 20/21, 10117 Berlin, Germany. oliver.gralla@charite.de
Haas
F
F
Knoll
N
N
Hadzidiakos
D
D
Tullmann
M
M
Romer
A
A
Deger
S
S
Ebeling
V
V
Lein
M
M
Wille
A
A
Rehberg
B
B
Loening
S A
SA
Roigas
J
J
D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D016896:Treatment Outcome