<p>Optimal Delivery of Follow-Up Care After Radical Cystectomy for Bladder Cancer</p>

Abstract

Purpose of Review: To identify components representing optimal delivery of follow-up care after radical cystectomy because of bladder cancer and report the current level of evidence. Methods: We conducted a systematic literature search of the following databases: Cochrane, MEDLINE, Embase, CINAHL, Web of Science, Physiotherapy Evidence Database and ClinicalTrials.gov. The search results were managed in Covidence Reference Manager and abstracts were screened by title. Articles relevant to the subject of interest were included and the results are reported narratively. Results: Several studies have evaluated the positive impact of enhanced recovery after surgery (ERAS) on length of stay, albeit not on the further impact on 90-day postoperative complication rate, functional recovery, or mortality. Minimally invasive surgery may result in a slighter shorter length of stay compared to open surgery. Physical training combined with nutritional intervention can improve functional recovery up to one year after surgery. Nutritional supplements can preserve muscle and bone mass, and potentially improve recovery. Patient education in stoma care and prevention of infection can significantly improve self-efficacy and avoid symptoms of infection postoperatively. Moreover, specific devices like applications (apps) can support these efforts. Continued smoking increases the risk of developing postoperative complications while no evidence was found on the impact of continued alcohol drinking. Currently, there is no evidence on psychological well-being, sexual health, or shared decision making interventions with an impact on rehabilitation after radical cystectomy. Conclusion: Data are scarce but indicate that peri-and postoperative multi-professional interventions can reduce prevalence of sarcopenia, and improve functional recovery, physical capacity, nutritional status, and self-efficacy in stoma care (level 1 evidence). Continued smoking increases the risk of complications, but the effects of a smoking and alcohol intervention remain unclear (level 3 evidence). The results of this review provide guidance for future directions in research and further attempts to develop and test an evidence-based program for follow-up care after radical cystectomy.

From fast-track to enhanced recovery after surgery in radical cystectomy pathways: A nursing perspective

“…Outcome reflecting quality of life and functional level have been suggested as more relevant outcome while real time recovery is happening after discharge owing to short LOS. 35,36 In reality, full recovery only occurs once normal baseline function has been restored/superseded and adverse symptoms have resolved. Thus, there are at least three stages to recovery (discharge from ICU recovery, discharge from hospital and return to baseline), and each stage needs to be satisfactorily achieved for complete recovery to occur.…”

Impact of COVID-19 crisis on medical care of patients with metastasized uro-oncologic disease under systemic cancer therapy: a multicenter study in German university hospitals

“…Others have installed an online oncology platform for communicating with cancer patients [ 3 ]. Digitalization, especially the use of social media sources for disseminating medical information to a large audience making them valuable campaigning instruments [ 27 ] or by providing applications (apps) to optimize follow-up care [ 28 ], has the potential to optimize oncologic patient care and in this way it has enormous potential for the field of UO. Therefore, the German health care system needs structured campaigns to speed up digitalization in the near future.…”

Cisplatin for cancer therapy and overcoming chemoresistance

“…BC comprises urothelial BC, squamous cell carcinoma in the bladder epithelium and muscle-invasive BC (MIBC) [ 166 ]. The standard treatment is a radical cystectomy followed by conventional chemotherapy [ 167 ] such as cisplatin, for which there is increased chemoresistance [ 168 ]. Yet it is highly treatable if detected during the early stages and the most common risk factor is smoking, as the tobacco in cigarettes contain carcinogens.…”