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. 2024 May 15;16(5):1620-1629.
doi: 10.62347/ZMUX1738. eCollection 2024.

Impact of fast-track surgery-oriented care pathways on perioperative rehabilitation indices in patients undergoing radical prostatectomy for prostate cancer

Mi Chen  1 , Hua Chen  2 , Liu He  1 , Linrong He  1 , Lijuan Zhang  1 , Qingrong Li  1 , Qiuling Lu  1 , Honglian Wen  1 , Li Chen  1 , Dandan Song  1
Affiliations

Impact of fast-track surgery-oriented care pathways on perioperative rehabilitation indices in patients undergoing radical prostatectomy for prostate cancer

Mi Chen et al. Am J Transl Res. .

Abstract

Objective: This study was conducted to evaluate the effects of Fast-Track Surgery (FTS)-oriented care pathways on perioperative rehabilitation indicators in patients undergoing radical prostatectomy for prostate cancer.

Methods: The clinical data of 120 patients admitted to Sichuan Cancer Hospital & Institute who underwent radical prostatectomy for prostate cancer from September 2020 to October 2022 were collected and retrospectively analyzed. The patients were divided into a control group (n=60, receiving standard care) and an FTS group (n=60 patients receiving FTS-oriented care) according to different nursing methods. The perioperative rehabilitation indices were compared between the groups.

Results: The FTS group exhibited shorter hospitalization duration (P=0.001), postoperative anal exhaust time (P=0.012), drain removal time (P=0.007), gastrointestinal recovery time (P=0.008), and a lower total complication rate (P=0.016) compared to the control group. The scores of Visual Analog Scale (VAS) (P=0.001, P=0.003, P=0.015) and Activities of Daily Living (ADL) (P=0.011, P=0.005, P=0.007) at 24, 48, and 72 hours postoperatively were significantly lower in the FTS group than in the control group. Hospitalization cost (P=0.002) and medication expenses (P=0.016) were notably lower in the FTS group. During a 12-month follow-up, the FTS group showed a significantly lower complication rates (3.33%) compared to the control group (18.33%) (P=0.009).

Conclusion: The application of FTS-oriented nursing pathway in patients undergoing radical prostatectomy for prostate cancer significantly enhances postoperative rehabilitation, reduces pain, lowers hospitalization and medication costs, and improves postoperative quality of life, which contributes positively to the nurse-patient relationship and patient outcome.

Keywords: Accelerated rehabilitation; fast-track surgery-oriented nursing pathway; pain management; perioperative rehabilitation indices; prostate cancer; quality of life; radical prostatectomy.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Flow diagram of research design.
Figure 2
Figure 2
Comparison of clinical indices. The FTS group exhibited significantly shorter duration of hospitalization, time to postoperative anal exhaust, drain removal, and gastrointestinal function recovery compared to the control group. Compared with the control group, *P<0.05. FTS: Fast-Track Surgery.
Figure 3
Figure 3
Comparison of postoperative complications between the two the groups. The total incidence of complications in the FTS group was 21.67% (13/60), which was significantly lower than 55.00% (33/60) in the control group (P<0.05). FTS: Fast-Track Surgery.
Figure 4
Figure 4
Comparison of postoperative pain intensity between the two groups. The VAS scores of patients in the FTS group were significantly lower than those in the control group at 24, 48, and 72 hours postoperatively. Compared with the control group, *P<0.05. VAS: Visual Analog Scale; FTS: Fast-Track Surgery.
Figure 5
Figure 5
Comparison of postoperative living ability between the two groups. The ADL scores of patients in the FTS group were significantly higher than those in the control group at 24, 48, and 72 hours postoperatively. Compared with the control group, *P<0.05. ADL: Activities of Daily Living; FTS: Fast-Track Surgery.
Figure 6
Figure 6
Comparison of hospitalization and medication costs between the two groups. The hospitalization expenses (A) and medication costs (B) of patients in the FTS group were significantly lower than those in the control group. Compared with the control group, *P<0.05. FTS: Fast-Track Surgery.
Figure 7
Figure 7
Comparison of patient satisfaction between the two groups. The satisfaction rate of patients in the FTS group was 100.00% (A), and the satisfaction rate was 98.33% in the control group (B), with no statistically significant difference between the two groups (P>0.05). FTS: Fast-Track Surgery.
Figure 8
Figure 8
Comparison of the occurrence of long-term complications. At the 12th month of follow-up, the complication rate in the FTS group was 3.33%, markedly lower than the 18.33% observed in the control group (P<0.05). FTS: Fast-Track Surgery.
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