The following is a summary of “Implementation of a comprehensive prehabilitation program for patients undergoing radical cystectomy” published in the February 2023 issue of Urologic Oncology by Smelser, et al.
There must be more comprehensive and well-coordinated pre-operative optimization programs for radical cystectomy (RC). Researchers at a high-throughput bladder cancer referral hospital assessed the viability and acceptability of a coordinated, multi-faceted prehabilitation program for RC patients. They conducted a narrative literature evaluation on rehabilitation in the management of bladder cancer, focusing on investigating more advanced evidence. They focused on areas with the most evidence and assembled a group of specialists from several fields to develop their curriculum.
All patients with RC as of February 1, 2021, will be required to participate in a full rehabilitation program following a specified predefined order. Clinical and demographic information was gathered prospectively. Stata version 13 was used to examine retention rates in the rehabilitation program. About 82 patients were enrolled between February and December 2021, and 67 (81%) had undergone RC as of the data cutoff date. The average age was 68 (SD 11) years, and 63 (76%) respondents were men. For 48 patients or 59%, neoadjuvant chemotherapy (NAC) was used.
Charlson’s comorbidity index averaged 3.8. (SD 2.3). All patients were checked for malnutrition, and 82% are now taking vitamins and minerals. Pre-operative physical therapy was utilized by 52% of patients. Complication rates during 30 days were 56%, and between 30 and 90 days, they were 40%. After introducing prehabilitation, resource length of stay (RLOS) decreased. The preliminary data suggest that implementing a complete prehabilitation program in a high-volume bladder cancer referral center is practicable and substantially impacts resource consumption and consequences.
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