Patient-reported extremity symptoms after robot-assisted laparoscopic cystectomy.

AIMS AND OBJECTIVES: To describe patient-reported extremity symptoms after robot-assisted laparoscopic cystectomy in patients with bladder cancer. BACKGROUND: Preventive activities for remaining patient safety due to correct positioning play an important part in perioperative nursing care.Extremity injuries are well-known after prolonged surgery, especially in robot-assisted urologic surgery in the steep Trendelenburg position. The risk of injury increases due to patient-related and operative risk factors. METHODS: A quantitative prospective observational study was conducted. Patients were followed up with the QuickDASH (Disabilities in the Arm, Shoulder and Hand), Lower Extremity Functional Scale (LEFS) and a study-specific questionnaire 7-10 days and monthly, up to six months after surgery in patients with extremity symptoms. The study adheres to STROBE (strengthening the reporting of observational studies in epidemiology) guidelines, see Supporting information File S1. RESULTS: Out of the 94 included participants, 46.8% (n = 44) experienced extremity symptoms 7-10 days after surgery. Pain, numbness and weakness were the most frequent symptoms. There was a discrepancy between the patients reported symptoms and the documentation in the patient records. Only 13.6% (n = 3) of the reported pain was documented, respectively 27.5% (n = 11) of other symptoms. CONCLUSION: A large proportion of the patients report postoperative extremity symptoms after robot-assisted laparoscopic cystectomy. Prevention of complications in the perioperative setting, are together with follow-ups, important nursing activities for maintaining patient safety and may both prevent and detect postoperative extremity symptoms and injuries. RELEVANCE TO CLINICAL PRACTICE: This study reveals the need of accurate documentation regarding extremity symptoms in digital patient records, as well as continuous follow-ups during the hospital stay and after hospital discharge to enable detection of treatable extremity injuries. The result of this study also indicates the importance of nursing activities such as evidence-based positioning guidelines in the operating theatre for optimal positioning.

Atención de enfermería en la administración preoperatoria de mitomicina C mediante EMDA / No disponible

Cada vez existen más estudios que demuestran la eficacia de la instilación de mitomicina C (MMC) mediante sistema EMDA prerresección transuretral (RTU), en pacientes con tumor vesical no músculo invasivo (TVNMI), disminuyendo la recidiva de tumor y aumentando el tiempo libre de enfermedad. El sistema EMDA es una técnica sencilla de realizar y de fácil aprendizaje por el personal de enfermería. Por lo que queremos mostrar su procedimiento y cuidados propios

There is an increasing number of studies that show the efficiency of instillation of mitomycin via a pre-resection transurethral (RTU) EMDA system, in patients with non-muscle invasive bladder cancer (TVNMI), by reducing the time of recurrence and increasing disease-free survival. EMDA system is a simple technique to carry out and easy to learn, so it is essential to show its procedure and nursing care

Bladder cancer: overview and disease management. Part 1: non-muscle-invasive bladder cancer.

Part 1 of this two-part article provides an overview of bladder cancer and discusses its management. Since publication of a previous article entitled 'Understanding the role of smoking in the aetiology of bladder cancer' ( Anderson, 2009 ), the author has received many requests for an update. This article provides an overview of bladder cancer and its current management practices, underlining the continued role of smoking as the predominant risk factor in the disease's development. The management of bladder cancer is governed by specific guidelines. Management of non-muscle-invasive cancers, including surgical intervention with transurethral resection, and intravesical therapy using chemotherapy and immunotherapy agents, is discussed. Cystectomy (removal of the bladder), is sometimes necessary. Treatments are effective in reducing tumour recurrence, but the effects of the risks and side-effects on the individual's quality of life can be significant. The prevalence of bladder cancer, and the nature of its management make this cancer one of the most expensive for the NHS to treat. The effectiveness of health promotional strategies in increasing peoples' awareness of their risk of developing the disease, and in enabling them to change long-term health behaviours is discussed. The role of the multidisciplinary team is explored, along with that of the uro-oncology cancer nurse specialist. Part 2 will consider the management of muscle-invasive and metastatic bladder cancer.

Profesiones de riesgo y cáncer vesical / No disponible

A nivel mundial, el 19 por mil de todos los cánceres es atribuible al medio ambiente. Está demostrada la influencia de los factores medioambientales en el desarrollo del cáncer vesical. En los países occidentales, en el varón es el 4º cáncer más frecuente y el 8º en mujeres. En este estudio trataremos de demostrar de qué modo influyen algunas profesiones de las denominadas de riesgo en el desarrollo del cáncer vesical (CV). Para ello realizamos un estudio epidemiológico observacional y retrospectivo, caso-control: 500 casos (diagnóstico de CV previo) y 500 controles, habitantes de la provincia de Cádiz, los controles emparejados en edad y sexo a los casos. Del estudio original, mucho más amplio, extraemos los resultados obtenidos para un determinado factor: "Profesiones de riesgo". Se compara la exposición relativa de cada grupo a dicha variable o factor tanto de forma global como para cada profesión de riesgo individualizada. Analizamos estadísticamente su influencia en función de la profesión de cada sujeto y su situación laboral, activo o jubilado, en el desarrollo de esta enfermedad. A la vista de los resultados concluimos que de forma global el tener una profesión de riesgo, sin ser un factor de riesgo estadísticamente significativo, se aproxima mucho a serlo. Individualmente, la profesión "construcción" sí muestra datos estadísticamente significativos sobre su incidencia en el CV

Globally, 19 per-mille of all cancers are attributable to the environment. The influence of environmental factors on the development of bladder cancer has been demonstrated. In the western countries, in the male is the 4th most frequent cancer and the 8th in women. In this study we will try to demonstrate how some occupations of the so-called risk factors influence the development of bladder cancer (CV). To do this, we performed an observational and retrospective epidemiological study, case-control: 500 cases (diagnosis of previous CV) and 500 controls, inhabitants of the province of Cádiz, controls matched in age and sex to the cases. From the original study, much more extensive we extract the results obtained for a certain factor: Risk occupations. The relative exposure of each group to that variable or factor is compared. We statistically analyze their influence depending on the occupation of each subject and their employment status, active or retired, in the development of this disease. In view of the results we conclude that in general, having a risk occupation, without being a statistically significant risk factor, it's close to being. Individually the occupation "construction" shows statistically significant data on its incidence in the CV

Cystectomy-Enhanced Recovery Program: Nursing Implications.

Cystectomy is a complex procedure with a tenuous perioperative course. Enhanced recovery programs (ERPs) are bundle strategies, developed to enhance the recovery of surgical patients. This article outlines the components of an ERP for cystectomy patients from a nursing implementation perspective.

Percutaneous Nephrostomy Infusion: Nursing Considerations for Treatment of Upper Urinary Tract Urothelial Carcinoma.

An intrarenal approach using a percutaneous nephrostomy tube is a novel method to deliver chemotherapy and biotherapy to patients with upper urinary tract urothelial carcinoma. A paucity of evidence exists regarding basic nursing implications for this unique treatment option. This column will provide suggested guidelines to administer intrarenal treatment via a percutanous nephrostomy tube.
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Perfil del paciente sometido a resección transuretral de neoplasia vesical / No disponible

Antecedentes y objetivos. El cáncer de vejiga es el séptimo tipo de cáncer más frecuentemente diagnosticado en los varones a nivel mundial. Su presentación clínica suele ser con síntomas de hematuria macro o microscópica. La resección endoscópica transuretral (RTU) es el pilar diagnóstico y terapéutico. El objetivo del presente trabajo fue describir el perfil del paciente que ingresa en una unidad de Urología para RTU de vejiga con el fin de detectar los posibles riesgos que puedan presentar. Pacientes y métodos. Estudio retrospectivo transversal descriptivo y analítico que incluyó 108 pacientes atendidos en la Unidad de Gestión Clínica de Urología del Hospital Universitario a los que se practicó RTU vesical a lo largo del año 2016. Los datos fueron obtenidos de las correspondientes historias clínicas electrónicas de urología y anestesia. Se recogieron las siguientes variables: edad, sexo, duración de la hospitalización, peso corporal y altura para obtención del índice de masa corporal (IMC), hábito tabáquico, ingesta habitual de alcohol, diagnóstico previo o tratamiento para hipertensión, dislipemia, diabetes mellitus y antecedentes de cáncer, así como estimación del riesgo anestésico mediante clasificación ASA (American Society of Anesthesiologists) y valoración funcional con escala NYHA (New York Heart Association) y determinaciones analíticas prequirúrgicas de hemograma y bioquímica plasmática. Resultados. El 91,7 por mil de los pacientes sometidos a RTU vesical fueron varones y la edad fue de 69,9 ± 11,3 años. Un 20,4 por mil era fumador. Un 38,0 por mil de los pacientes presentó sobrepeso y un 38,9 por mil obesidad. La prevalencia de hipertensión, dislipemia, diabetes y cáncer previo fue del 63,9 por mil el 40,7 por mil , el 25,9 por mil y el 25,9 por mil , respectivamente. Un 62,0 por mil presentaba un riesgo anestésico ASA de clase II, seguido de un 25,9 por mil que lo presentaba clase III. La valoración funcional mediante escala NYHA más prevalente, 93,5 por mil , fue la de clase I. La cifra media de hemoglobina fue de 12,4 ± 2,2 g/dl. La duración media de hospitalización fue de 2,8 ± 4,4 días. En conclusión, el perfil del paciente sometido a RTU vesical es varón, de edad avanzada, con sobrepeso u obesidad además de elevada prevalencia de otros factores de riesgo cardiovascular como HTA, dislipemia y diabetes, con riesgo anestésico clase II, es decir con enfermedad sistémica leve, controlada y no incapacitante, sin limitación de la actividad física de causa cardíaca y con anemia leve

Background and objectives. Bladder cancer is the seventh most commonly diagnosed cancer in men worldwide. Its clinical presentation is usually with symptoms of macro or microscopic hematuria. Transurethral endoscopic resection (TUR) is the diagnostic and therapeutic mainstay. The objective of the present study was to describe the profile of the patient who enters a urology unit for bladder TUR in order to detect possible risks that they may present. Patients and Methods. A descriptive and analytical cross-sectional retrospective study that included 108 patients treated at the Urology Clinical Unit of the University Hospital, who underwent TUR throughout 2016. The data were obtained from the corresponding electronic medical histories of surgery and anesthesia. The following variables were collected: age, sex, duration of hospitalization, body weight and height to obtain body mass index (BMI), smoking habits, habitual alcohol intake, previous diagnosis or treatment for hypertension, dyslipidemia, diabetes mellitus, cancer, as well as anesthesia risk estimation using the American Society of Anesthesiologists (ASA) and NYHA (New York Heart Association) functional assessment and pre-surgical blood chemistry and biochemical analytical determinations. Results. Ninety-one percent of the patients undergoing bladder TUR were male and the age was 69.9 ± 11.3 years, 20.4 per-mille were smokers, 38.0 per-mille of the patients were overweight and 38.9 per-mille were obese. The prevalence of hypertension, dyslipidemia, diabetes and previous cancer was 63.9 per-mille , 40.7 per-mille , 25.9 per-mille and 25.9 per-mille , respectively. A 62.0 per-mille presented a class II ASA anesthetic risk, followed by 25.9 per-mille that presented class III ASA. The most prevalent NYHA functional assessment, 93.5 per-mille , was class I. The mean hemoglobin level was 12.4 ± 2.2 g / dl. The mean duration of hospitalization was 2.8 ± 4.4 days. In conclusion, the profile of the patient submitted to bladder TUR is a male, elderly with overweight or obesity, as well as a high prevalence of other cardiovascular risk factors such as hypertension, dyslipidemia and diabetes, with a class II anesthesia risk, with mild systemic disease, non-disabling, without limitation of physical activity of cardiac cause and with mild anemia

Cuidados de enfermería en la ureteroileostomía (tipo Bricker). Estudio de un caso clínico / No disponible

La alta incidencia y elevada prevalencia de casos de cáncer de vejiga, traducido ello en un creciente número de ingresos hospitalarios, hacen de esta patología un grave problema de salud pública. A pesar de la elevada incidencia, la mortalidad no es tan alta, debido a que es este un proceso oncológico en muchas ocasiones curable. El diagnóstico precoz de este proceso oncológico es el medio más eficaz de combatir el tumor, cuya capacidad de disminución se produce en una fase avanzada de su evolución. El papel de la enfermería es fundamental para el paciente de cirugía, transmitiendo información sobre el proceso y ayudándole en la adopción de actitudes positivas frente a la enfermedad

The (high incidence and) high prevalence of cases of bladder cancer are provoking an increased number of hospital admissions, making this disease a major public health problem. Despite the high incidence, mortality is not high, as this is a curable cancer process in many situations. Early diagnosis of this cancer is the most effective combat strategy, as the ability to decrease tumours occurs in an advanced stage of their development environment. The role of nursing care is essential for the surgery patient, transmitting information about the process and helping he or she in the adoption of positive attitude

Actuación de enfermería en el tratamiento del tumor vesical con láser ambulante con anestesia local / No disponible

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Bladder cancer: Risk factors, diagnosis, and management.

Bladder cancer is the most common genitourinary cancer in the United States. Symptoms of bladder cancer mimic those of a urinary tract infection, which can delay timely diagnosis. Because of the high rate of bladder cancer, it is likely advanced practice registered nurses will be responsible for the care of patients with bladder cancer. This article reviews the signs and symptoms of bladder cancer along with management options to safely care for this patient population.

Quimiohipertermia intravesical con mitomicina C. Actuación de enfermería / No disponible

La técnica que está utilizando enfermería en pacientes seleccionados con tumor vesical de alto grado se denomina "quimiohipertermia intravesical con mitomicina C". El objetivo del siguiente trabajo es mostrar el procedimiento llevado a cabo en nuestro servicio mediante la utilización del sistema Combat. La administración intravesical de mitomicina C mediante este sistema de circulación en circuito cerrado permite alcanzar una temperatura de 43ºC, favoreciendo de este modo la instilación a capas más profundas de la vejiga. Este método requiere de un aprendizaje previo y utilización adecuada del mismo con el fin de obtener una baja tasa de suspensión del tratamiento por efectos adversos

The technique that is using nursing in selected patients with bladder tumor of high degree is called "intravesical quimiohipertermia with Mitomycin C". The aim of this study is to show the procedure carried out in our service using the Combat system. The intravesical administration of mitomycin C through this system of movement in closed circuit allows to reach a temperature of 43ºC, there by favouring the instillation to deeper layers of the bladder. This method requires a prior learning and proper use of the same in order to obtain a low rate of discontinuation of treatment due to adverse effects

[NURSING CARE TO A PATIENT WITH INTRAVESICAL TREATMENT]. / Atención de enfermería a un paciente en tratamiento intravesical.

INTRODUCTION: Bladder cancer is one of the most frequent in developed countries. It is the 4th most frequent cancer in men and the 9th in women. The main risk factor is the smoking habit and its main symptom is hematuria. One of the therapies used in its treatment is the Bacillus Calmette-Guerin intravesical (BCG). OBJECTIVE: TO carry out a specific care plan to a patient treated with BCG and improve the information delivered to the patient and family. MATERIAL AND METHODS: An observational study of a nursing plan of care through a clinical case. A bibliographical research was carried out in the main Spanish and English databases to collect articles published in the last 5 years. Subsequently, the studies of the Spanish M.a T Luis, C. Ferndndez and M.a V. Navarro were adopted in the model suggested by V. Henderson and NANDA, NIC and NOC taxonomy. RESULTS: The nursing assessment is performed through V. Henderson's 14 needs and the Collaboration Problem was detected: Hematuria, secondary to bladder cancer and the nursing diagnosis: <>. For the planning and execution the following NOC were selected: Knowledge: management of the cancer and Knowledge: therapeutic procedure, and the NIC and its corresponding activities and their evaluation. CONCLUSION: The Nursing Care Process application with a personalised and standardised language, guarantees a quality healthcare and continuity. Moreover, it sets common targets for the nursing team. It tries to show how an appropriate control of the symptoms can be carried out at home, when the cares are taught and organised by adapting the oral or written information to each patient.

Implementing hexaminolevulinate HCl blue light cystoscopy: a nursing perspective.

Hexaminolevulinate HCl is a diagnostic imaging agent used with blue light during cystoscopy to help detect non-muscle-invasive bladder cancer. Blue light cystoscopy performed using hexaminolevulinate HCl has been found to detect more papillary non-muscle-invasive bladder tumors than cystoscopy performed using standard white light. Because bladder instillation and retention requirements of hexaminolevulinate during cystoscopy can affect patient flow in the perioperative setting, this technique necessitates changes in nursing practice and care of patients with known or suspected non-muscle-invasive bladder cancer. Nursing personnel at one facility followed the AORN guidelines for preoperative patient care in the ambulatory setting to address staffing, preoperative nursing assessment, anesthesia evaluation, and preoperative teaching related to implementing blue light cystoscopy.

A case report and review of transitional cell carcinoma in children.

Transitional cell carcinoma (TCC) is a rare cause of hematuria in children. This type of urothelial bladder tumor is typically low grade and carries a good prognosis. In this article, a case report is presented along with a review of the literature on TCC in children.

Haematuria: from identification to treatment.

Haematuria has a prevalence of 0.1% to 2.6%. Potential diagnoses may include infection, kidney stones, trauma, exercise or spurious causes, such as foods, drugs or menstruation, and a tumour. Approximately 20% of patients with haematuria have a urological tumour, with a further 20% found to have a significant underlying pathology. Haematuria is subsequently known as the 'classic presentation' of bladder cancer with 70-80% of patients experiencing painless, gross (visible) haematuria. However, in all cases of visible haematuria, a tumour should be suspected until proven otherwise. A patient with visible haematuria requires urgent, stringent investigation, warranting specialist assessment and subsequent selective referral through a series of patient-centred investigations at a haematuria clinic. One-stop clinics have been shown to improve the patient experience in early diagnosis of potentially life-threatening conditions. Yet despite morbidity and mortality from bladder cancer increasing, the haematuria service has remained largely unchanged for several decades. This paper will discuss the tests and investigations that need to be undertaken in an individual with either visible or non-visible haematuria, and outline the care that is needed to support patients through the investigation process, with special focus on bladder tumour.

Patient safety improvement through in situ simulation interdisciplinary team training.

In situ simulation is an education strategy that promotes patient safety and enhances interdisciplinary teamwork. When a patient is experiencing an acute health status change or a rapidly emerging condition, teamwork is necessary to adequately and appropriately provide treatment. A unit-based quality improvement project was designed to enhance these skills. In situ simulation was used as the training venue for nurses and physicians to practice the techniques recommended in the evidence-based team-building model, TeamSTEPPS.

Experiencia de Enfermería Urológica en el paciente TVNMI tratado con quimio-hipertermia / No disponible

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