The Usefulness of the Critical Pathway for Radical Retropubic Prostatectomy / 대한비뇨기과학회지

ABSTRACT

PURPOSE: The critical pathway (CP) for radical retropubic prostatectomy (RRP), which is the efficient standardized guideline of clinical practice, was established for all the medical staff, nurses, patients and hospital managers for managing patients with RRP. The aim of this study was to evaluate the usefulness of this CP for RRP. MATERIALS AND METHODS: Our series consisted of 256 consecutive patients who had undergone RRP at a single institution from March 1, 2002 till May 31, 2005. The CP of RRP was implemented January 1, 2004. The patients were subdivided into two groups (1) the non critical pathway (NCP) group that was made of 91 patients who were treated other than by the CP (from March, 2002 through December, 2003) and (2) the CP group of 134 patients who were placed on CP (from January, 2004 through May, 2005). The factors compared in this study included the average length of stay (LOS), the average hospital charges, the postoperative complications and the patient satisfaction between the two groups. RESULTS: There were no significant differences in the parameters between the two groups including age, the prostate-specific antigen (PSA) level, the Gleason score and the stage. The average LOS decreased significantly after implementation of CP without increasing the incidence of postoperative complications. The average hospital charges were significantly lower for the CP group than for the group without CP. The patients in the CP group were more satisfied than the other patients. CONCLUSIONS: The CP for RRP seems to be effective practical guidelines for managing radical retropubic prostatectomy patients.