Elaboração de protocolos de alta ambulatorial de hospital terciário e seguimento nos centros de atenção à saúde primária e secundária para pacientes tratados de neoplasias urológicas

Abstract

Urological neoplasms are becoming increasingly prevalent in recent years, mainly due to decreased mortality from more effective treatments and increased life expectancy. This trend has considerably increased the number of patients with urological cancers being followed up in services around the world, leading to overload and patient dissatisfaction.At the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, from January 2017 to April 2019, 905 new case consultations were carried out and only 249 patients were discharged from the service. The elaboration of specific protocols for long-term follow-up, to be applied in the primary and secondary health care sectors, where specialists do not work, becomes a necessary tool for tertiary cancer treatment services that may reduce the number of outpatient consultations less complex, in addition to reducing the need for patients to travel with the possibility of exams close to their home.The objective of the study, therefore, was to create follow-up protocols for urological treated neoplasms, with a low risk of recurrence, to be applied at the primary and secondary levels of health care. The recommendations of the main international societies and the risk of tumor recurrence, considering the tumor staging associated with the histological factors of the primary tumor were analyzed. Protocols were developed to monitor prostate, bladder, and kidney tumors, with a low risk of recurrence, to be applied to primary and secondary health care levels. There was a need for arbitrary definition of some criteria due to lack of literature, however it is a pioneering attitude that may result in the rationalization of the resources of the Brazilian Unified Health System (SUS).