G Poinas1, J L Blache2, D Kassab-Chahmi3, P L Evrard4, P M Artus5, P Alfonsi6, X Rébillard7, M Beaussier8, Y Cerantola9, P Coloby10, É Drapier11, N Houédé12, A Masson-Lecomt5, M Rouprêt13, L Le Normand14, X Gamé15, P O Bosset16, L Delaunay17, J P Fendler18, C Ecoffey19, G Cuvelier20. 1. Clinique Beau Soleil, 119, avenue Lodève, 34070 Montpellier, France. Electronic address: gregoire.poinas@gmail.com. 2. Institut Paoli Calmette, 13009 Marseille, France. 3. ICFuro/AFU, 75017 Paris, France. 4. Clinique Bizet, 75016 Paris, France. 5. Hôpital Saint-Louis, 75010 Paris, France. 6. Hôpital privée Saint-Joseph, 75014 Paris, France. 7. Clinique Beau Soleil, 119, avenue Lodève, 34070 Montpellier, France. 8. Institut Mutualiste Montsouris, 75014 Paris, France. 9. CHU vaudois, 1011 Lausanne, Suisse. 10. Centre hospitalier René-Dubos, 95300 Pontoise, France. 11. Centre d'urologie Alphonse de Saintonge, 17000 La Rochelle, France. 12. CHU Carémeau, 30029 Nîmes, France. 13. Hôpital Pitié-Salpétrière, 75013 Paris, France. 14. Hôpital Hôtel Dieu, 44000 Nantes, France. 15. CHU Rangueil, 31400 Toulouse, France. 16. Hôpital Foch, 92150 Suresnes, France. 17. Clinique générale, 74000 Annecy, France. 18. Hôpital Saint-Joseph Saint-Luc, 69007 Lyon, France. 19. CHU Pontchaillou, 35000 Rennes, France. 20. Centre Hospitalier de Cornouaille, 29107 Quimper, France.
Abstract
INTRODUCTION: The enhanced recovery program (ERP) is a management mode whose objective is to reduce the risk of complications and allow the patient to recover more quickly all its functional capacities and to reintegrate at most quickly and safely in his usual environment. This intentionally synthetic document aims to disseminate in the urological community the main points of the ERP recommendations for cystectomy. This work, coordinated by AFU, involves several other partners. The full document is available on the "Urofrance" website. Another article will follow on organizational measures. METHOD: The development of the recommendations is based on the method "formalized consensus of experts" proposed by the HAS. The report is based on a systematic review of the literature (January 2006-May 2017), two rounds of iterative quotations and a national proofreading. Levels of proof of conclusions and gradation of recommendations are based on the HAS grid. RESULTS: The bibliographic strategy made it possible to retain 298 articles. Only the recommendations that obtained a strong agreement after the two rounds of iterative listing were retained. The recommendations presented here are in chronological form (before, during, after hospitalization). Twenty-six key points on the technical and organizational measures of ERP have been identified. CONCLUSION: The result of the literature review, supplemented by expert opinion, suggests a significant clinical interest in the application and dissemination of ERP for cystectomy, despite the limited data available for this indication.
INTRODUCTION: The enhanced recovery program (ERP) is a management mode whose objective is to reduce the risk of complications and allow the patient to recover more quickly all its functional capacities and to reintegrate at most quickly and safely in his usual environment. This intentionally synthetic document aims to disseminate in the urological community the main points of the ERP recommendations for cystectomy. This work, coordinated by AFU, involves several other partners. The full document is available on the "Urofrance" website. Another article will follow on organizational measures. METHOD: The development of the recommendations is based on the method "formalized consensus of experts" proposed by the HAS. The report is based on a systematic review of the literature (January 2006-May 2017), two rounds of iterative quotations and a national proofreading. Levels of proof of conclusions and gradation of recommendations are based on the HAS grid. RESULTS: The bibliographic strategy made it possible to retain 298 articles. Only the recommendations that obtained a strong agreement after the two rounds of iterative listing were retained. The recommendations presented here are in chronological form (before, during, after hospitalization). Twenty-six key points on the technical and organizational measures of ERP have been identified. CONCLUSION: The result of the literature review, supplemented by expert opinion, suggests a significant clinical interest in the application and dissemination of ERP for cystectomy, despite the limited data available for this indication.