Outpatient Radical Prostatectomy - Surgical and Anesthetic Considerations (ORP-SAC)
Outpatient Radical Prostatectomy - Surgical and Anesthetic Considerations - Open Label Randomized Pilot Study
Radical prostatectomy has become the gold standard treatment for prostate cancer.
Regarding of morbidity of access on open retropubic radical prostatectomy a lot of centers around the world start to develop laparoscopic and robotic approach over the past years. The problems regarding this techniques is that the pure laparoscopic prostatectomy shows a steep learning curve with a high initial complication rate, and the use of robotic assistance surgery despite of lower learning curve is associated with higher surgical supply and operative room costs. These costs may have a significant impact on overall cost of prostate cancer care especially in Brazil.
In Brazil, the open route for radical prostatectomy is still the most frequent approach. One of the disadvantages of open prostatectomy from the other surgeries is the longest hospital stay. However, the question of what length of stay after this operation is optimal and necessary is unresolved. In this trial the investigators have compared a randomized group of patients that had discharged on postoperative day 2, 1 and same day surgery. The investigators had intent to evaluate the feasibility of ambulatory open radical prostatectomy (patient discharge in the same day of surgery - average 12 hours of hospitalization) maintaining patient satisfaction and safety.
Visão geral do estudo
Status
Condições
Descrição detalhada
Radical prostatectomy initially described by Walsh (1982) has become the gold standard treatment for prostate cancer and has evolved enormously over the last 25 years. Improvements include the use of smaller incisions, reduced blood loss, shorter hospital stays, and surgical refinement. Several large series with long-term follow-up have confirmed that this approach results in excellent cancer control and functional results in terms of preservation of erectile potency and urinary continence.
Regarding of morbidity of access on open retropubic radical prostatectomy a lot of centers around the world start to develop laparoscopic and robotic approach over the past years. The problems regarding this techniques is that the pure laparoscopic prostatectomy shows a steep learning curve with a high initial complication rate, and the use of robotic assistance surgery despite of lower learning curve is associated with higher surgical supply and operative room costs. These costs may have a significant impact on overall cost of prostate cancer care especially in Brazil where nowadays only have 3 centers with 5 robots.
In Brazil, the open route for radical prostatectomy is still the most frequent approach, mainly out of large cities. One of the disadvantages of open prostatectomy from minimally invasive surgeries is the longest hospital stay. However, the question of what length of stay after this operation is optimal and necessary is unresolved. In this trial the investigators have compared a randomized group of patients that had discharged on postoperative day 2, 1 and same day surgery. The investigators had intent to evaluate the feasibility of ambulatory open radical prostatectomy (patient discharge in the same day of surgery - average 12 hours of hospitalization) while maintaining patient satisfaction and safety.
Tipo de estudo
Inscrição (Real)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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São Paulo
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Barretos, São Paulo, Brasil, 14784400
- Barretos' Cancer Hospital
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
- clinically localized Prostate Cancer (PCa)
- underwent open radical retropubic prostatectomy at Barretos' Cancer Hospital by a single primary surgeon (EFF)
- patients which the procedure went without any complications
- body mass index ≤ 30 kg/m2
Exclusion Criteria:
- Important comorbidities
- history of bleeding diathesis
- taking blood thinners
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição fatorial
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Comparador Ativo: patient discharge on postoperative day 2
The patient was discharge on postoperative day 2 (as was done routinely)
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The patient was discharge on postoperative day 2 (as was done routinely)
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Experimental: patient discharge on postoperative day 1
The patient was discharge on postoperative day 1
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The patient was discharge on postoperative day 1
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Experimental: patient discharge in the day of surgery
The patient was discharge in the evening of the same day of surgery (average 12 hours of hospitalization)
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The patient was discharge in the evening of the same day of surgery (average 12 hours of hospitalization)
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Feasibility of ambulatory open radical prostatectomy while maintaining patient satisfaction and safety.
Prazo: 2 weeks postoperatively
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The endpoint regarding the survey is the comparison with standard group discharged at postoperative day 2. The satisfaction was considered non similar when there were more than 1 negative answer for any question or any patient in comparison to standard group in these questions: Do you consider your postoperative care adequate ?
/ Was your understanding of the necessary postoperative care adequate before enrolling for this study?
Was your pain control adequate?
/ Was the length of hospitalization adequate?
/ Would you choose to have the procedure again with the same length of hospitalization?
/ Did you take any analgesic postoperatively after being discharged?
/ Did you take any analgesic postoperatively after being discharged?
/ Have you received adequate medical and nurse's care during the post-operative period?
/ Did you consider the access to the hospital easy if you needed it?
/ Would you recommend other men undergo this procedure the same way you?
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2 weeks postoperatively
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Igor RM Franklin, MD, Barretos' Cancer Hospital
- Cadeira de estudo: Eliney F Faria, PhD, Barretos' Cancer Hospital
- Diretor de estudo: Wesley J Magnabosco, MD, Barretos' Cancer Hospital
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Estimativa)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- OORP-2011
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