Application of case management mode combined with enhanced recovery after surgery in the perioperative period of patients with diode laser enucleation of prostate

Abstract

Objective To explore the application value of case management mode combined with enhanced recovery after surgery (ERAS) in the perioperative period of patients with diode laser enucleation of prostate. Methods A total of 106 patients with benign prostatic hyperplasia who were treated in the Third Department of Urology of Hu'nan Provincial People's Hospital from January 2017 to June 2018 were selected. These patients were divided into observation and control groups according to the odd and even numbers of the admission order, with 53 cases in each group. The two groups were treated by diode laser enucleation of prostate by continuous epidural anesthesia. The observation group received perioperative management according to the case management mode combined with ERAS program. The control group received traditional perioperative management. The first time of anal exhaust, the time of ambulation, the length of bladder irrigation and indwelling catheter, the complications, hospitalization days after surgery, the total cost during hospitalization, the pain score on the first day after operation, the International Prostate Symptom Score (IPSS) and the maximal urinary flow-rate (Qmax) on the second day after catheter removal were compared between two groups. Results In the observation group, the first time of anal exhaust, the first time of ambulation, the time of bladder irrigation, the duration of indwelling catheter, the duration of hospitalization, the fee of hospitalization were (19.60±2.98) h, (1.63±0.57) d, (1.58±0.50) d, (3.44±0.80) d, (4.92±1.19) d and (10.94±4.5) thousand yuan respectively, which were lower than those of the control group [ (27.75±4.67) h, (3.57±0.99) d, (3.53±0.83) d, (5.06±0.99) d, (7.70±1.81) d and (27.8±4.5) thousand yuan] , and the differences were statistically significant (P 0.05) . Conclusions The case management mode combined with ERAS concept can accelerate postoperative rehabilitation of patients with diode laser enucleation of prostate, reduce postoperative complications, shorten hospitalization day and reduce hospitalization costs. Key words: Benign prostatic hyperplasia; Perioperative nursing; Rehabilitation; Enhanced recovery after surgery; Case management; Diode laser enucleation of prostate