THE ROLE OF SURGICAL PATIENT ENHANCEMENT TEAM (SPET) IN POST OPERATIVE RECOVERY OF PATIENTS WHO UNDERWENT LAPAROSCOPIC RADICAL NEPHRECTOMY THROUGH TRANS-PERITONEAL VERSUS RTROPERITONEAL ACCESS

Abstract

Objective: To evaluate the impact of surgical patient enhancement team (SPET) in post-operative recovery of patients who had laparoscopic radical nephrectomy through Trans-peritoneal versus retroperitoneal access.

Study Design: Quasi experimental study.

Place and Duration of Study: Medway NHS Trust Hospital for renal masses, United Kingdom, from Aug 2013 and Oct 2014.

Methodology: During our study duration ninety patients underwent Laparoscopic Radical nephrectomy at Medway NHS Trust Hospital for renal masses. Fifty three patients had Laparoscopic Trans-peritoneal Nephrectomy (LTN) and 23 had Laparoscopic Retroperitoneal nephrectomy (LRN). Demographic and clinico-pathological parameters were compared for the two groups.

Results: The two groups were comparable for age, gender, pre and post-operative blood parameters, length of hospital stay and post-operative complication. The analgesia requirement was statistically significant for Laparoscopic Trans-peritoneal nephrectomy group with high pain score however with the involvement of surgical patient enhancement team the patients were safely discharged home on a comparable date to Laparoscopic Retroperitoneal nephrectomy group. \

Conclusion: The two approaches are comparable and with the added support of surgical patient enhancement team, the patients with Trans-peritoneal radical nephrectomy could be safely and efficiently discharged.