The Usefulness of the Critical Pathway for Radical Retropubic Prostatectomy

Sangchul Lee; Byong Chang Jeong; Eunsik Lee

doi:10.4111/kju.2006.47.10.1029

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Lee, Jeong, and Lee: The Usefulness of the Critical Pathway for Radical Retropubic Prostatectomy

Original Article

Korean Journal of Urology

Korean Journal of Urology 2006; 47(10): 1029-1034.

Published online: 31 October 2006

DOI: https://doi.org/10.4111/kju.2006.47.10.1029

The Usefulness of the Critical Pathway for Radical Retropubic Prostatectomy

Sangchul Lee, Byong Chang Jeong, Eunsik Lee

Department of Urology, Seoul National University College of Medicine, Seoul, Korea.

Corresponding author (eslee@snu.ac.kr)

Received 24 May 2006 Accepted 12 July 2006

Abstract

Purpose

The critical pathway (CP) for radical retropubic prostatectomy (RRP), which is the efficient standardized guideline of clinical practice, was established for all the medical staff, nurses, patients and hospital managers for managing patients with RRP. The aim of this study was to evaluate the usefulness of this CP for RRP.

Materials and Methods

Our series consisted of 256 consecutive patients who had undergone RRP at a single institution from March 1, 2002 till May 31, 2005. The CP of RRP was implemented January 1, 2004. The patients were subdivided into two groups: (1) the non critical pathway (NCP) group that was made of 91 patients who were treated other than by the CP (from March, 2002 through December, 2003) and (2) the CP group of 134 patients who were placed on CP (from January, 2004 through May, 2005). The factors compared in this study included the average length of stay (LOS), the average hospital charges, the postoperative complications and the patient satisfaction between the two groups.

Results

There were no significant differences in the parameters between the two groups including age, the prostate-specific antigen (PSA) level, the Gleason score and the stage. The average LOS decreased significantly after implementation of CP without increasing the incidence of postoperative complications. The average hospital charges were significantly lower for the CP group than for the group without CP. The patients in the CP group were more satisfied than the other patients.

Conclusions

The CP for RRP seems to be effective practical guidelines for managing radical retropubic prostatectomy patients.

Keywords: Critical pathways, Prostatectomy, Prostatic neoplasms

Figures and Tables

Table 1

Collaborative course of care in the critical pathway for radical retropubic prostatectomy patients

^*: preoperative, ^†: intravenous, ^‡: mid-day nulli (non) per os, ^§: postoperative, ^∥: nulli (non) per os, ^¶: Jackson-Pratt, ^**: pro re nata

Table 2

Characteristics of the patients (NCP group vs. CP group)

NCP: non critical pathway, CP: critical pathway, ASA: American Society of Anesthesiologists, PSA: prostate-specific antigen, RRP: radical retropubic prostatectomy, T-stage: tumor stage

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