No one likes to be in the hospital longer than needed. Now, a “fast-track” approach to prostate cancer surgery using a combination of existing techniques may help men get home within 24 hours of having their prostates removed—without putting them at extra risk of complications.
That finding, from a study comparing a fast-track prostate surgery pathway with a standard approach that keeps patients in the hospital for up to three days, was presented at the American Urological Association’s annual meeting in Anaheim, Calif., by researchers from the Comprehensive Cancer Center. It’s the first study of its kind.
The U-M’s 24-hour approach stood up to the prospective comparison well, yielding high patient satisfaction rates and low complication rates almost exactly like those seen with standard care, says senior author Martin Sanda, associate professor of surgery, of urology and of internal medicine, and associate director of the Health System’s prostate cancer program.
Sanda and his colleagues devised the pathway, which uses epidural anesthesia, non-narcotic pain relief and tailored patient education materials to help early-stage prostate cancer patients get home sooner, just as safely and with less expense. They then compared it prospectively with standard care in 153 patients operated on in the year 2000 by two U-M surgeons.
The U-M treatment approach doesn’t rely on any medical advance—just coordinated 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 allow the patient to be more alert and active soon after surgery, and specially developed education materials.