New Approach to Surgery Shortens Hospital Stay

A study has found that a "fast-track” prostate surgery approach gets men home within 24 hours, compared with up to three days for the standard approach, and with the same high patient satisfaction and low complication rates seen with standard care. The study was presented at the annual meeting of the American Urological Association in Anaheim (CA, USA).

The new approach was developed by researchers at the University of Michigan Medical School (U-M, Ann Arbor, USA). They devised a pathway that uses epidural anesthesia, non-narcotic pain relief, and patient educational materials to help early-stage prostate cancer patients get home sooner, just as safely, and with less expense. They then compared this pathway with standard care in 153 patients who were operated on by U-M surgeons and found that the results were nearly the same.

The new approach coordinates use of a lower-body epidural anesthesia that avoids the "hangover” effect of general anesthesia, non-narcotic pain drugs such as ketorolac and ibuprofen that let patients be more alert and active soon after surgery, and specially developed educational materials that help patients and their families know what to expect regarding postoperative care and at-home care. Just by combining these elements and making a determined effort to offer the patients the option of going home after 24 hours, the U-M team was able to send 77% of patients home after one day's stay, while maintaining a satisfaction rate of 94% and a postoperative complication rate of about 5% In most cases, there was less use of narcotic pain relievers and most were discontinued on the same day as the surgery.

"Since prostatectomy is the most common treatment for early-stage prostate cancer, and indeed is one of the most common cancer operations overall, a more streamlined approach could have a major impact on both patient experience and cost of care,” noted Martin Sanda, M.D., associate professor of urology at U-M and senior author of the study.




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