Difference between revisions of "Cystectomy"
From WikiAnesthesia
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{{Infobox surgical case reference | {{Infobox surgical case reference | ||
| anesthesia_type = | | anesthesia_type = General / Neuraxial | ||
| airway = | | airway = ETT | ||
| lines_access = | | lines_access = Partial: PIV x 1 (20) <br/> | ||
| monitors = | Radical: PIV x 2 (18 or 16) | ||
| monitors = Partial: Standard <br/> | |||
Radical: Std + art line | |||
| considerations_preoperative = | | considerations_preoperative = | ||
| considerations_intraoperative = | | considerations_intraoperative = | ||
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=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> === | === Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> === | ||
* If spinal used, ensure T4 sensory level | |||
** Consider using epi in spinal to prolong block | |||
* Can consider placing epidural if significant post-op pain anticipated | |||
== Intraoperative management == | == Intraoperative management == | ||
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=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> === | === Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> === | ||
* Supine | |||
* Sometimes females placed in lithotomy | |||
=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> === | === Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> === | ||
* If radical cystectomy, have T&S and consider T&C 2 units | |||
=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> === | === Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> === | ||
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=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> === | === Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> === | ||
* Bleeding | |||
== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> == | == Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> == | ||
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|+ | |+ | ||
! | ! | ||
!Radical cystectomy | |||
!Partial Cystectomy | !Partial Cystectomy | ||
! | !Open cystectomy | ||
!Minimally invasive cystectomy | |||
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|Unique considerations | |Unique considerations | ||
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|Position | |Position | ||
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|Surgical time | |Surgical time | ||
|4-6 hours | |||
|~ 2 hours (urinary diversion not required) | |||
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|EBL | |EBL | ||
|300-1500 | |||
|Minimal | |||
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|Postoperative disposition | |Postoperative disposition | ||
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|Pain management | |Pain management | ||
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|Potential complications | |Potential complications | ||
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Revision as of 10:51, 16 April 2021
Cystectomy
| Anesthesia type |
General / Neuraxial |
|---|---|
| Airway |
ETT |
| Lines and access |
Partial: PIV x 1 (20) |
| Monitors |
Partial: Standard |
| Primary anesthetic considerations | |
| Preoperative | |
| Intraoperative | |
| Postoperative | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
A cystectomy is the removal of all or part of the urinary bladder. Most commonly, this procedure is to address cancer.
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Neurologic | |
| Cardiovascular | |
| Respiratory | |
| Gastrointestinal | |
| Hematologic | |
| Renal | |
| Endocrine | |
| Other |
Labs and studies
Operating room setup
Patient preparation and premedication
Regional and neuraxial techniques
- If spinal used, ensure T4 sensory level
- Consider using epi in spinal to prolong block
- Can consider placing epidural if significant post-op pain anticipated
Intraoperative management
Monitoring and access
Induction and airway management
Positioning
- Supine
- Sometimes females placed in lithotomy
Maintenance and surgical considerations
- If radical cystectomy, have T&S and consider T&C 2 units
Emergence
Postoperative management
Disposition
Pain management
Potential complications
- Bleeding
Procedure variants
| Radical cystectomy | Partial Cystectomy | Open cystectomy | Minimally invasive cystectomy | |
|---|---|---|---|---|
| Unique considerations | ||||
| Position | ||||
| Surgical time | 4-6 hours | ~ 2 hours (urinary diversion not required) | ||
| EBL | 300-1500 | Minimal | ||
| Postoperative disposition | ||||
| Pain management | ||||
| Potential complications |