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. 2012:2012:382843.
doi: 10.5402/2012/382843. Epub 2012 Mar 8.

Current Strategies to Enhance Recovery following Radical Cystectomy: Single Centre Initial Experience

Nikhil Vasdev  1 , Praveen L Pillai, Christopher P Snowdon, Andrew C Thorpe
Affiliations

Current Strategies to Enhance Recovery following Radical Cystectomy: Single Centre Initial Experience

Nikhil Vasdev et al. ISRN Urol. 2012.

Abstract

A radical cystectomy (RC) with pelvic lymph node dissection is the gold standard treatment for muscle-invasive bladder carcinoma. The morbidity associated with RC is clearly lower than that in the previous decades; it still continues to remain higher than 30% in the early postoperative period associated with and remains the most effective method for local control. We present current strategies being developed to further enhance recovery in patients undergoing RC and stratifying these into pre, intra, and post operative. We present our current strategies to enhance revcovery in patients undergoing RC which includes a combination of a through preoperative assessment with cardiopulmonary exercise (CPX), preoperative carbohydrate loading drinks, and intraoperative fluid monitoring with the trans-oesophageal Doppler probe (TODP) that may enhance recovery following radical cystectomy. We conclude that using these strategies may not only help in reducing peri/post operative morbidity and the duration of inpatient stay but may also help in enhancing the patient's long-term recovery.

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Figures

Figure 1
Figure 1
CPX machine (a) and patient performing CPX test (b).
Figure 2
Figure 2
An abnormal CPX trace.
Figure 3
Figure 3
Our intraoperative fluid challenge protocol is being monitored with the trans-oesophageal Doppler probe during radical cystectomy.
See this image and copyright information in PMC

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