Application of a protocol for enhanced recovery after radical cystectomy: a before-and-after cohort study
- 06.07.2023
- Original Article
Erschienen in:
- Verfasst von
- Claudia Brusasco
- Antonia Di Domenico
- Marco Ennas
- Andrea Benelli
- Federico Dotta
- Mattia Tosi
- Martina Manfredi
- Tiziana Calcagno
- Fabio Campodonico
- Federico Germinale
- Andrea Montevecchi
- Francesco Corradi
- Carlo Introini
- Erschienen in
- World Journal of Urology | Ausgabe 8/2023
Abstract
Purpose
Radical cystectomy with urinary diversion is a major urological surgery burdened both by a high rate of short- and long-term complications and by a high emotional and psychological impact. Post-operative recovery is extremely important and the application of ERAS protocols can facilitate the return to functional autonomy. The aim of the present study was to verify the efficacy of our ERAS programme on outcomes of recovery after surgery of patients undergoing radical cystectomy with various urinary diversions.
Methods
This is a before–after study comparing the historical group (n. 77) of radical cystectomies following a peri-operative standard of care with the prospective observational group (n. 83) following our ERAS programme. Recovery after surgery outcomes evaluated were length of stay, re-admission rate at 30–90/days and post-operative complications.
Results
Patients treated following the ERAS protocol presented less intra-operative blood loss (p < 0.001) and less intra-operative fluid infusions (p < 0.001). Time of first flatus was shorter in the ERAS group, though no difference was found in timing of nasogastric tube removal and defecation. Removal of drainage was done significantly earlier in the ERAS group. The median length of stay decreased from 12 to 9 days (p = 0.003) with a significant reduction also in re-admission rates at 30 and long-term complications at 90 days from surgery.
Conclusion
The application of an opioid-free ERAS protocol to patients undergoing open radical cystectomy was associated, as compared with prior traditional care, with significant reductions of recovery time and length of stay, number of total in-hospital complications, in particular functional ileus and re-admissions by 30 and 90 days after surgery.
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- Titel
- Application of a protocol for enhanced recovery after radical cystectomy: a before-and-after cohort study
- Verfasst von
-
Claudia Brusasco
Antonia Di Domenico
Marco Ennas
Andrea Benelli
Federico Dotta
Mattia Tosi
Martina Manfredi
Tiziana Calcagno
Fabio Campodonico
Federico Germinale
Andrea Montevecchi
Francesco Corradi
Carlo Introini
- Publikationsdatum
- 06.07.2023
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
World Journal of Urology / Ausgabe 8/2023
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726 - DOI
- https://doi.org/10.1007/s00345-023-04468-y
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