Cystectomy

From WikiAnesthesia
Cystectomy
Anesthesia type General / Neuraxial
Airway ETT
Lines and access Partial: PIV x 1 (20)
Radical: PIV x 2 (18 or 16)
Monitors Partial: Standard
Radical: Std + art line
Primary anesthetic considerations
Preoperative
Intraoperative
Postoperative


A cystectomy is the removal of all or part of the urinary bladder. Most commonly, this procedure is performed 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

References