title: Impact of a clinical pathway in patient care following surgery on laparoscopic radical prostatectomy.
abstract: 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.
authors.affiliation: Department of Preventive Medicine, Hospital La Paz, Madrid, Spain.
authors.forename: César Llorente
authors.initials: CL
authors.lastname: Parrado
authors.forename: Sergio
authors.initials: S
authors.lastname: Alonso y Gregorio
authors.forename: Auxiliadora
authors.initials: A
authors.lastname: Martín-Martínez
authors.forename: Alberto
authors.initials: A
authors.lastname: Martín-Vega
authors.forename: Juan García
authors.initials: JG
authors.lastname: Caballero
authors.forename: Jesús Javier de la Peña
authors.initials: JJ
authors.lastname: Barthel
mesh_terms: 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