Surgical safety in radical cystectomy: the anesthetist's point of view-how to make a safe procedure safer.

Engel, Dominique; Furrer, Marc A.; Wüthrich, Patrick Y.; Löffel, Lukas M. (2019). Surgical safety in radical cystectomy: the anesthetist's point of view-how to make a safe procedure safer. (In Press). World journal of urology Springer-Verlag 10.1007/s00345-019-02839-y

[img] Text
Engel_Radical Cystectomy Safety_Review_WJUR_2019.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (524kB) | Request a copy

PURPOSE The aim of this review is to present an anesthesiological overview on surgical safety for radical cystectomy implementing the cornerstones of today's rapidly evolving field of perioperative medicine. METHODS This is a narrative review of current perioperative medicine and surgical safety concepts for major surgery in general with special focus on radical cystectomy. RESULTS The tendency for perioperative care and surgical safety is to consider it a continuous proactive pathway rather than a single surgical intervention. It starts at indication for surgery and lasts until full functional recovery. Preoperative optimization leads to superior outcome by mobilizing and/or increasing physiological reserve. Multidisciplinary teamwork involving all the relevant parties from the beginning of the pathway is crucial for outcome rather than an isolated specialist approach. This fact has gained importance in times of an ageing frail population and rising health care cost. We also present our 2019 Cystectomy Enhanced Recovery Approach for optimization of perioperative care for open radical cystectomy in a high caseload center. CONCLUSIONS With the implementation of in itself simple but crucial steps in perioperative medicine such as multimodal prehabilitation, safety checks, better perioperative monitoring and enhanced recovery concepts, even complex surgical procedures such as radical cystectomy can be performed safer. Emphasis has to be laid on a more global view of the patients' path through the perioperative process than on the surgical procedure alone.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology

UniBE Contributor:

Engel, Dominique; Furrer, Marc; Wüthrich, Patrick Yves and Löffel, Lukas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0724-4983

Publisher:

Springer-Verlag

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

08 Aug 2019 07:13

Last Modified:

22 Oct 2019 23:14

Publisher DOI:

10.1007/s00345-019-02839-y

PubMed ID:

31201522

Uncontrolled Keywords:

Patient safety Perioperative medicine Radical cystectomy

BORIS DOI:

10.7892/boris.131785

URI:

https://boris.unibe.ch/id/eprint/131785

Actions (login required)

Edit item Edit item
Provide Feedback