We retrospectively reviewed clinicopathologic data of 772 consecutive patients who underwent RP between 2009 and 2017, excluding patients who received adjuvant therapy and those without a nadir PSA level less than 0.2 ng/ml. We examined all PSA values measured during the actual follow-up. Meanwhile, we estimated the PSA value when we observed the "optimal PSA follow-up schedule" at each timing of virtual follow-up. BCR was defined as an elevation of PSA to greater than 0.2 ng/ml. We considered that the ideal PSA range for detection of BCR should be set at 0.2 to 0.4 ng/mL in order to start salvage treatment without delay. Therefore, the primary objective of this study was to examine whether BCR could be detected before PSA exceeded 0.4 ng/mL when we complied with the "optimal PSA followup schedule". We also compared the frequency of virtual follow-up (PSA measurement) to that of actual.RESULTS: During the mean follow-up period of 5.8 years, 115 (14.9%) patients developed BCR and the frequency of virtual follow-up was significantly lower than the actual frequency (5.8 vs 13.5 times, p<0.001). However, BCR was overlooked (detecting BCR when PSA exceeded 0.4 ng/ml) in 17 (2.2%) patients, which was higher than the actual frequency of 12 (1.6%) patients. Therefore, we modified the follow-up schedule as shown in the lower of Table, which resulted in a significantly lower follow-up frequency (7.4 times, p<0.001) and less incidence of overlooking of BCR (7 patients, 0.9%).CONCLUSIONS: This external validation study revealed that the "modified optimal PSA follow-up schedule after RP" could reduce the frequency of PSA measurement with a limited risk of overlooking BCR. We believe this schedule could decrease medical expenses and the burden on both physicians and patients.
90.6% (n 29) received oral maltodextrins 2 hours before the procedure, no bowel preparation was performed in 81.3% (n 26), all patients received intravenous antibiotic and antithrombotic prophylaxis. in the postoperative period, comprehensive holistic care and control were provided in accordance with best practices; a satisfaction survey was used, guaranteeing quality care and continuous improvement in the processes. Conclusion: The multidisciplinary work of ERAS team and the nursing care that is provided to the person, holistically in the three phases; before, during and after the colorectal surgery has given results and improvements of patients. Especially satisfaction, an irrevocable element because in the Civil Hospital of Guadalajara Fray Antonio Alcalde "The health of our people is the supreme law" (La Salud del Pueblo es la Suprema Ley).
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