The evidence-based pathway for peri-operative management of open and robotically assisted laparoscopic radical prostatectomy.
OBJECTIVE
To assess reports supporting the novel and comprehensive evidence-based pathway for radical prostatectomy (RP), as collaborative-care pathways have helped to optimize management of patients treated with RP and such clinical pathways provide an ideal framework for constructing an original evidence-based pathway for the complete peri-operative care of these patients.


METHODS
We searched for articles on Medline via PubMed to identify reports describing consensus opinions on appropriate aspects of the peri-operative management of patients treated with RP, specifically seeking to discern information on preoperative antibiotic regimen, peri-operative laboratory testing, use of beta-blockers for those at cardiac risk, pulmonary treatment, deep venous thrombosis prophylaxis, diet advancement, pain management, anti-emetic use, bowel regimen, and catheter removal after RP.


RESULTS
Available reports were used to substantiate each variable of our collaborative-care pathway for RP. When available, meta-analyses were used to provide a broad review of the recognized clinical research. Otherwise, many controlled studies and retrospective reviews were relied upon to provide evidence to construct a framework for clinical decision-making.


CONCLUSIONS
This is the first pathway for the peri-operative management of major urological procedure that is well integrated into current literature. The critical aspects of clinical decision-making in the patient treated with RP were validated by the available research.
Kaufman
Melissa R
MR
Department of Urologic Surgery, Vanderbilt University, Nashville, TN, USA.
Baumgartner
Roxelyn G
RG
Anderson
Laura W
LW
Smith
Joseph A
JA
Chang
Sam S
SS
Herrell
S Duke
SD
Cookson
Michael S
MS
D016063:Blood Loss, Surgical; D003657:Decision Making; D019317:Evidence-Based Medicine; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D011468:Prostatectomy / Q000295:instrumentation* / Q000379:methods; D011471:Prostatic Neoplasms / Q000601:surgery*; D012371:Robotics; D016896:Treatment Outcome