Surgical and medical co-management optimizes surgical outcomes in older patients with chronic diseases undergoing robot-assisted laparoscopic radical prostatectomy

Abstract

Introduction

While robotic-assisted laparoscopic radical prostatectomy (RRP) is a standard mode for localized prostate cancer (PC), the risk of complications in older patients with chronic diseases and complex medical conditions can be a deterrent to surgery. Surgical and medical co-management (SMC) is a new strategy to improve patients’ healthcare outcomes in surgical settings.

Methods

We reviewed the clinical data of older patients with chronic diseases who were cared for with SMC undergoing RRP in our hospital in the past 3 years and compared them with the clinical data from the general urology ward. Preoperative conditions and related indicators of recovery, and incidence of postoperative complications with the Clavien Grade System were compared between these two groups.

Results

The indicators of recovery were significantly better, and the incidence rates of complications were significantly reduced in the SMC group at grades I–IV (p < 0.05), as compared to the general urology ward group.

Conclusions

The provision of care by SMC for older patients focused on early identification, comorbidity management, preoperative optimization, and collaborative management would significantly improve surgical outcomes. The SMC strategy is worthy of further clinical promotion in RRP treatment in older men with chronic diseases and complex medical conditions.

Keywords:

• Robot-assisted laparoscopic radical prostatectomy
• surgical and medical co-management
• older
• complications
• preoperative
• postoperative

Acknowledgments

The authors thank Xu Zhang, Qingbo Huang, and Yang Fan for their insightful review of the content and technical support.

Author contributions

WL and CL analyzed the data and wrote the paper; JH and RW collected the patient’s data and gave the detailed analysis, DG and RC were responsible for the patient’s therapy, and follow-up. All authors contributed to the writing and review of the manuscript and approved the final version.

Disclosure statement

No potential conflict of interest was reported by the author(s).