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Implementation of a comprehensive prehabilitation program for patients undergoing radical cystectomy
Woodson W Smelser1, Jacob E Tallman2, Veerain K Gupta2
1Division of Urology, Washington University in St. Louis, MISSOURI, Saint Louis, MO.
Urologic Oncology
|November 20, 2022
Summary
A new prehabilitation program for radical cystectomy (RC) patients is feasible and acceptable. Early results show modest improvements in resource use and complications for bladder cancer care.
Area of Science:
- Urology
- Oncology
- Surgical Optimization
Background:
- Radical cystectomy (RC) for bladder cancer often lacks comprehensive preoperative optimization.
- Prehabilitation programs aim to improve patient outcomes before major surgery.
Approach:
- A narrative literature review identified key prehabilitation domains for bladder cancer.
- A multidisciplinary team designed a coordinated, multi-faceted prehabilitation program.
- The program was implemented as standard care for RC patients starting February 2021.
Key Points:
- 82 patients undergoing RC were enrolled; 67 completed the surgery.
- High adherence was observed for nutritional support (82%) and physical therapy (52%).
- Early data suggests a decline in resource length of stay post-implementation.
Conclusions:
- Implementing a comprehensive prehabilitation program for RC is feasible at a high-volume center.
- The program shows early promise in modestly impacting resource consumption and complication rates.
- Further research is needed to fully elucidate the long-term benefits of prehabilitation in RC.
