Impact of a clinical pathway in patient care following surgery on laparoscopic radical prostatectomy.
OBJECTIVE
The aim of this study was to evaluate the impact of clinical pathway (CP) implementation in laparoscopic radical prostatectomy (LRP) has had on patient care and clinical evolution after discharge.


METHODS
Eighty-six patients were included in 2 groups: first group was composed of patients operated since the new technique (LRP) was used until the CP was implemented (26 patients operated in 2002) and, second group, with 60 patients, followed the CP during 2004 and 2005.


RESULTS
The operative time was reduced from 377.7 to 172.3 minutes after the CP implementation. The duration of bladder catheterization decreased by more than 10 days (from 26.17 to 15.85 days) and that of thromboprophylaxis was reduced from 6.44 to 3.38 days. No difference was found in the rate of complications in the first month after surgery, nor was there any difference in the rate of occurrence of erectile dysfunction, incontinence, and biochemical recurrence during the first year after surgery.


CONCLUSIONS
After the implementation of the CP, there have been better results in patient care, such as reduction in the duration of catheterization and thromboprophylaxis. In comparison with other studies, we observed a clear reduction in length of stay and operative time. However, there is still room for improvement in reducing the duration of catheterization.
Parrado
César Llorente
CL
Department of Preventive Medicine, Hospital La Paz, Madrid, Spain.
Alonso y Gregorio
Sergio
S
Martín-Martínez
Auxiliadora
A
Martín-Vega
Alberto
A
Caballero
Juan García
JG
Barthel
Jesús Javier de la Peña
JJ
D000368:Aged; D019091:Critical Pathways; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011182:Postoperative Care; D011468:Prostatectomy / Q000379:methods*; D013030:Spain