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Optimal Delivery of Follow-Up Care After Radical Cystectomy for Bladder Cancer

PURPOSE OF REVIEW: To identify components representing optimal delivery of follow-up care after radical cystectomy because of bladder cancer and report the current level of evidence. METHODS: We conducted a systematic literature search of the following databases: Cochrane, MEDLINE, Embase, CINAHL, W...

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Autores principales: Jensen, Bente Thoft, Lauridsen, Susanne Vahr, Jensen, Jørgen Bjerggaard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7569073/
https://www.ncbi.nlm.nih.gov/pubmed/33117747
http://dx.doi.org/10.2147/RRU.S270240
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author Jensen, Bente Thoft
Lauridsen, Susanne Vahr
Jensen, Jørgen Bjerggaard
author_facet Jensen, Bente Thoft
Lauridsen, Susanne Vahr
Jensen, Jørgen Bjerggaard
author_sort Jensen, Bente Thoft
collection PubMed
description PURPOSE OF REVIEW: To identify components representing optimal delivery of follow-up care after radical cystectomy because of bladder cancer and report the current level of evidence. METHODS: We conducted a systematic literature search of the following databases: Cochrane, MEDLINE, Embase, CINAHL, Web of Science, Physiotherapy Evidence Database and ClinicalTrials.gov. The search results were managed in Covidence Reference Manager and abstracts were screened by title. Articles relevant to the subject of interest were included and the results are reported narratively. RESULTS: Several studies have evaluated the positive impact of enhanced recovery after surgery (ERAS) on length of stay, albeit not on the further impact on 90-day postoperative complication rate, functional recovery, or mortality. Minimally invasive surgery may result in a slighter shorter length of stay compared to open surgery. Physical training combined with nutritional intervention can improve functional recovery up to one year after surgery. Nutritional supplements can preserve muscle and bone mass, and potentially improve recovery. Patient education in stoma care and prevention of infection can significantly improve self-efficacy and avoid symptoms of infection postoperatively. Moreover, specific devices like applications (apps) can support these efforts. Continued smoking increases the risk of developing postoperative complications while no evidence was found on the impact of continued alcohol drinking. Currently, there is no evidence on psychological well-being, sexual health, or shared decision making interventions with an impact on rehabilitation after radical cystectomy. CONCLUSION: Data are scarce but indicate that peri- and postoperative multi-professional interventions can reduce prevalence of sarcopenia, and improve functional recovery, physical capacity, nutritional status, and self-efficacy in stoma care (level 1 evidence). Continued smoking increases the risk of complications, but the effects of a smoking and alcohol intervention remain unclear (level 3 evidence). The results of this review provide guidance for future directions in research and further attempts to develop and test an evidence-based program for follow-up care after radical cystectomy.
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spelling pubmed-75690732020-10-27 Optimal Delivery of Follow-Up Care After Radical Cystectomy for Bladder Cancer Jensen, Bente Thoft Lauridsen, Susanne Vahr Jensen, Jørgen Bjerggaard Res Rep Urol Review PURPOSE OF REVIEW: To identify components representing optimal delivery of follow-up care after radical cystectomy because of bladder cancer and report the current level of evidence. METHODS: We conducted a systematic literature search of the following databases: Cochrane, MEDLINE, Embase, CINAHL, Web of Science, Physiotherapy Evidence Database and ClinicalTrials.gov. The search results were managed in Covidence Reference Manager and abstracts were screened by title. Articles relevant to the subject of interest were included and the results are reported narratively. RESULTS: Several studies have evaluated the positive impact of enhanced recovery after surgery (ERAS) on length of stay, albeit not on the further impact on 90-day postoperative complication rate, functional recovery, or mortality. Minimally invasive surgery may result in a slighter shorter length of stay compared to open surgery. Physical training combined with nutritional intervention can improve functional recovery up to one year after surgery. Nutritional supplements can preserve muscle and bone mass, and potentially improve recovery. Patient education in stoma care and prevention of infection can significantly improve self-efficacy and avoid symptoms of infection postoperatively. Moreover, specific devices like applications (apps) can support these efforts. Continued smoking increases the risk of developing postoperative complications while no evidence was found on the impact of continued alcohol drinking. Currently, there is no evidence on psychological well-being, sexual health, or shared decision making interventions with an impact on rehabilitation after radical cystectomy. CONCLUSION: Data are scarce but indicate that peri- and postoperative multi-professional interventions can reduce prevalence of sarcopenia, and improve functional recovery, physical capacity, nutritional status, and self-efficacy in stoma care (level 1 evidence). Continued smoking increases the risk of complications, but the effects of a smoking and alcohol intervention remain unclear (level 3 evidence). The results of this review provide guidance for future directions in research and further attempts to develop and test an evidence-based program for follow-up care after radical cystectomy. Dove 2020-10-14 /pmc/articles/PMC7569073/ /pubmed/33117747 http://dx.doi.org/10.2147/RRU.S270240 Text en © 2020 Jensen et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Jensen, Bente Thoft
Lauridsen, Susanne Vahr
Jensen, Jørgen Bjerggaard
Optimal Delivery of Follow-Up Care After Radical Cystectomy for Bladder Cancer
title Optimal Delivery of Follow-Up Care After Radical Cystectomy for Bladder Cancer
title_full Optimal Delivery of Follow-Up Care After Radical Cystectomy for Bladder Cancer
title_fullStr Optimal Delivery of Follow-Up Care After Radical Cystectomy for Bladder Cancer
title_full_unstemmed Optimal Delivery of Follow-Up Care After Radical Cystectomy for Bladder Cancer
title_short Optimal Delivery of Follow-Up Care After Radical Cystectomy for Bladder Cancer
title_sort optimal delivery of follow-up care after radical cystectomy for bladder cancer
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7569073/
https://www.ncbi.nlm.nih.gov/pubmed/33117747
http://dx.doi.org/10.2147/RRU.S270240
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