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Optimizing Outcomes in Urological Surgery: Preoperative Care

机译：优化泌尿外科手术中的结果：术前护理

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Purpose: Understanding best practices in preoperative care is critical for quality of care for our urology patients. We compiled a concise resource that provides recommendations for optimizing preoperative outcomes for patients undergoing urological surgery. Materials and Methods: Urological preoperative care was defined as medical evaluation or treatment received in preparation for surgery or a procedure. The Preoperative White Paper Panel was comprised of practicing urologists and nurses. The topic was researched via literature published from 1980 through 2018 which focused on preoperative evaluation and safety. Best practice recommendations were also reviewed from specialty societies. Recommendations in this article reflect expert opinion from the Panel, and are based on review of available evidence and existing best practice statements. Results: Preoperative optimization involves a good assessment and stratification of surgical risk for the patient about to undergo surgery or a procedure. This assessment starts with a timely history and physical evaluation, as well as review of underlying frailty and cognition. The assessment helps inform potential postoperative needs. Risk stratification calculators are available to determine potential cardiac and pulmonary morbidity as well as overall surgical risk. Optimization of endocrine and gastrointestinal comorbidities can also reduce complications for patients. Modifiable preoperative behaviors and needs such as malnutrition and smoking cessation should also be discussed before surgery. Conclusions: We summarize the preoperative factors that may impact surgical outcomes in urology. By understanding and applying best practices for preoperative care, urologists can optimize the quality of care for their patients
机译：目的：了解术前护理的最佳实践对于我们的泌尿外科患者的护理质量至关重要。我们编制了一项简洁的资源，为进行泌尿外科手术的患者优化优化术前结果提供建议。材料和方法：泌尿外科术前护理被定义为在制备手术或手术方面接受的医学评估或治疗。术前白皮书面板由实践泌尿科医生和护士组成。该主题是通过1980年至2018年发布的文献研究，专注于术前评估和安全。特别社会还审查了最佳实践建议。本文建议反映了小组的专家意见，并根据现有证据和现有最佳实践陈述的审查。结果：术前优化涉及患者进行手术或程序的良好评估和分层。该评估始于及时的历史和物理评估，以及对潜在的脆弱和认知的审查。评估有助于提供潜在的术后需求。风险分层计算器可用于确定潜在的心脏和肺部发病率以及整体手术风险。内分泌和胃肠道合并症的优化也可以减少患者的并发症。在手术前也应该讨论可修改的术前行为和需求，例如营养不良和吸烟停止。结论：我们总结了可能影响泌尿外科外科结果的术前因素。通过了解和应用术前护理的最佳实践，泌尿科医生可以优化患者的护理质量

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