Early recovery program in the radical surgical treatment of patients with prostate cancer: experience of the specialized hospital

Abstract

Background. Currently, there are sufficient data on the favorable role of fast track program on the course of postoperative period. Nevertheless, the role of these protocols being already included in the standards of the surgical treatment of many cancers is not clear to date in oncourology in general and in the prostate cancer (PC). Objective: to determine the effect of fast track program elements for the results of treatment in patients after radical prostatectomy. Materials and methods. 86 radical minimally invasive (laparoscopic or endoscopic extraperitoneal) prostatectomies were performed for prostate cancer in the period from May 2015 to February 2016 in the Oncological Research Institute named after N.N. Petrov. Patients were divided into 2 groups: in patients of the 1st (n = 44) group included those with traditional surgical management fast track elements were not used at all or were used partly; in the 2nd group (n = 42) these elements were used in a whole volume. We have assessed an influence of fast track elements on the frequency of perioperative and early postoperative complications, operative time, duration of the hospitalization and duration of the stay in intensive care unit, frequency of the repeated surgical interventions, and frequency of the repeated hospitalizations within 30 days of the postoperative period. Results. The presence and the absence of preoperative preparation did not affect an incidence of intraoperative complications. Intraoperative blood loss did not lead to blood transfusions. There were no significant differences in the incidence of 30-day complications between groups. When evaluating postoperative parameters there was difference between 1st and 2nd groups in the pelvis drainage (3.3 and 0.9 days, respectively, p = 0.002), an average duration of catheterization (11.2 and 5.2 days, respectively, p = 0.0003) and duration of hospitalization (15.1 and 6.5 days, respectively, p = 0.0008). Conclusion. Application of fast track program of perioperative management of patients with prostate cancer does not affect the frequency of intraand postoperative complications, but economically it is potentially more feasible, primarily by reducing the term of the patient stay in hospital.