Pelvic Lymph Node Dissection

'''Retroperitoneal Pelvic Lymph Node Dissection '''

DISCHARGE INSTRUCTIONS

It was a pleasure participating in your care.

-You may shower 2 days after surgery, but do not tub bathe, swim, soak, or scrub incision for 2 weeks. Bandage strips will fall off over time. If you have staples, they will be removed at your follow-up appointment.

-You may resume taking all of your home medications

-No heavy lifting for 4 weeks.

-Seek medical attention for fevers (temp>101.5), worsening pain, drainage or excessive bleeding from incision, chest pain or shortness of breath.

-Follow up with your urologist in 1-2 weeks.

-Please do not drive or consume alcohol while taking pain medications.

HOSPITAL COURSE:

Patient was admitted to Urology after undergoing a retroperitoneal pelvic lymph node dissection. No concerning intraoperative events occurred; please see dictated operative note for details. He was transferred to the floor from the PACU in stable condition. Patient had adequate pain control His diet was slowly advanced starting with sips after flatus and was tolerating a house diet at discharge. His incision was C/D/I, with no evidence of hematoma collection or infection. The remainder of the hospital course was relatively unremarkable, and he was discharged in stable condition, ambulating independently, and with adequate pain control. He was given explicit instructions to follow-up in clinic in 1-2 weeks.

'''PATHWAY '''

Po pain meds once tolerating toast and crackers. Pain is often a big issue with these patients due to large incision and youth. Often toradol can be given ask Chief.

Encourage ambulation, chest PT if needed, deep breaths.

Diet: POD1 usually d/c NGT, sips, POD2 clears until flatus then, toast and crackers, ADAT

 Dulc supp is used for these patients if needed.

<p style="margin: 0in 0in 0pt">HLIV when po intake >400cc

<p style="margin: 0in 0in 0pt">Labs: Basic metabolic, mag until on house diet, CBC, POD 1 then at Chief discretion.

<p style="margin: 0in 0in 0pt">Home POD 3-5

<p style="margin: 0in 0in 0pt">'''Discharge meds: '''

<p style="margin: 0in 0in 0pt">Oxycodone #45

<p style="margin: 0in 0in 0pt">Colace #60

<p style="margin: 0in 0in 0pt">