目的:描述一种用于治疗神经源性下尿路(LUT)功能障碍的泌尿重建或改道手术前标准化术前一天评估的概念,并评估其可行性及其对护理路径的影响。
方法:纳入我们机构在2017年1月至2021年12月期间在尿路重建或衍生手术治疗神经源性LUT功能障碍之前接受一天标准化评估的所有患者。数据从标准化报告中回顾性收集。主要结果是评估期间计划的测试和咨询的完成率。次要结果包括一日评估的结果以及一年内不同时间点泌尿外科手术策略的变化。
结果:101名患者从这一天的标准化评估中获益。收集的数据的总体完整性率为77.5%,从2017年的62.3%增加到2021年的89.3%。术前评估后,19.1%的患者修改了泌尿外科手术计划。然后通过多学科会议确认了114例患者(87.0%)的适应症,并在第二年对89例患者(67.9%)进行了不变。为18.3%的患者提出了相关的结肠造口术,最终在11.5%的患者中进行了。
结论:在进行重建或改道手术治疗神经源性LUT功能障碍之前,进行标准化的多学科术前一天评估似乎是可行的,并且可以优化手术计划并适应护理过程。
方法:
OBJECTIVE: To describe a concept of standardized preoperative one-day evaluation before urinary reconstructive or diversion surgery for the treatment of neurogenic lower urinary tract (LUT) dysfunction, and to evaluate its feasibility and its impact on the care pathway.
METHODS: All patients who underwent a one-day standardized evaluation before a urinary reconstructive or derivation surgery for the treatment of neurogenic LUT dysfunction between January 2017 and December 2021 in our institution were included. Data were collected retrospectively from standardized reports. The main outcome was the rate of completion of the tests and consultations planned during this evaluation. Secondary outcomes included the findings from the one-day evaluation and changes in the urological surgical strategy at different time points within one year.
RESULTS: One hundred and thirty-one patients benefited from this one-day standardized evaluation. The overall completeness rate of the data collected was 77.5%, increasing from 62.3% in 2017 to 89.3% in 2021. The urological surgical plan was modified for 19.1% of patients following this preoperative evaluation. The indication was then confirmed for 114 patients (87.0%) by the multidisciplinary meeting and was carried out unchanged during the following year for 89 patients (67.9%). An associated colostomy procedure was proposed for 18.3% of patients and was finally performed in 11.5%.
CONCLUSIONS: A standardized multidisciplinary preoperative one-day evaluation before performing reconstructive or diversion surgery for the treatment of neurogenic LUT dysfunction seems feasible and makes it possible to optimize the surgical plan and adapt the course of care.
METHODS: