Nursing-led multidisciplinary ERAS collaboration improves early recovery after laparoscopic radical prostatectomy for localized prostate cancer: a retrospective cohort study

护理主导的多学科ERAS协作可改善局限性前列腺癌腹腔镜根治性前列腺切除术后的早期康复:一项回顾性队列研究

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Abstract

BACKGROUND: Postoperative recovery after laparoscopic radical prostatectomy (LRP) is influenced by perioperative nursing care. Therefore, this retrospective study aimed to compare outcomes from nursing-led perioperative multidisciplinary nursing collaboration based on Enhanced Recovery After Surgery (PMNC) with standard care in 235 patients undergoing LRP for localized prostate cancer. METHODS: A retrospective cohort study was conducted in 235 patients with localized prostate cancer undergoing LRP at a tertiary hospital in Southwest China. Patients received either standard care (n = 115, routine perioperative nursing in 2020-2021) or PMNC (n = 120, implemented in 2022), which comprised eight structured ERAS-based interventions delivered jointly by nurses, anesthesiologists, and urologists. Primary outcomes were time to ambulation, catheter removal, urinary incontinence at discharge, and hospital stay; secondary outcomes included pain at 24/48 h, complications, 30-day readmission, and time to oral intake. Outcomes were compared using t-tests, Mann-Whitney U, chi-square, or Fisher's exact tests, with significance set at P < 0.05. RESULTS: The PMNC group showed significantly earlier ambulation (14.1 vs. 17.8 h, P < 0.001), earlier catheter removal (4.4 vs. 5.4 days, P < 0.001), shorter hospital stay (5.2 vs. 6.1 days, P < 0.001), and lower incontinence at discharge (32.5% vs. 56.5%, P < 0.001). Pain scores were also lower at 24 h (P < 0.001) and 48 h (P < 0.001). Multivariate logistic regression confirmed PMNC as an independent protective factor for early continence (OR = 0.47, 95% CI: 0.28-0.80, P = 0.005). CONCLUSION: A structured PMNC model was associated with improved early recovery after LRP, including faster mobilization, earlier catheter removal, lower incontinence rates, shorter hospitalization, and reduced pain.

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