Carmen Pozo1, Shahrokh F Shariat1,2,3,4, David D'Andrea1, Harun Fajkovic1, Mohammad Abufaraj1,5. 1. Department of Urology, Medical University of Vienna, Vienna, Austria. 2. Department of Urology, Weill Cornell Medical College, New York, New York. 3. Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. 4. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. 5. Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.
Abstract
PURPOSE OF REVIEW: Enhanced Recovery after Surgery (ERAS) programs are multimodal and interdisciplinary protocols, which aim to accelerate patient recovery and improve surgical outcomes through standardized perioperative care. In this review, we summarized the items included in most currently utilized protocols for patients undergoing radical cystectomy and we discussed the reported outcomes after the implementation. RECENT FINDINGS: Current protocols are mostly extrapolated from the colorectal surgery literature, and solid evidence in radical cystectomy is limited. Moreover, the items included in the protocols differ between countries and institutions, which make it difficult to quantify the individual contribution of each intervention to the overall effect of the ERAS program. Length of hospital stay (LOS), commonly used as a surrogate outcome of perioperative recovery, is reported to be lower for patients who benefited from an ERAS protocol. Complications and readmission rates showed no benefit to the ERAS protocols in most studies. SUMMARY: Although randomized controlled trials are needed to determinate the effect of the different items on patient recovery and the overall impact of ERAS program, available data support these protocols for patients undergoing radical cystectomy leading to a shorter LOS without increasing readmission or complication rates.
PURPOSE OF REVIEW: Enhanced Recovery after Surgery (ERAS) programs are multimodal and interdisciplinary protocols, which aim to accelerate patient recovery and improve surgical outcomes through standardized perioperative care. In this review, we summarized the items included in most currently utilized protocols for patients undergoing radical cystectomy and we discussed the reported outcomes after the implementation. RECENT FINDINGS: Current protocols are mostly extrapolated from the colorectal surgery literature, and solid evidence in radical cystectomy is limited. Moreover, the items included in the protocols differ between countries and institutions, which make it difficult to quantify the individual contribution of each intervention to the overall effect of the ERAS program. Length of hospital stay (LOS), commonly used as a surrogate outcome of perioperative recovery, is reported to be lower for patients who benefited from an ERAS protocol. Complications and readmission rates showed no benefit to the ERAS protocols in most studies. SUMMARY: Although randomized controlled trials are needed to determinate the effect of the different items on patient recovery and the overall impact of ERAS program, available data support these protocols for patients undergoing radical cystectomy leading to a shorter LOS without increasing readmission or complication rates.
Authors: Pietro Maria Lombardi; Michele Mazzola; Alessandro Giani; Sara Baleri; Marianna Maspero; Paolo De Martini; Monica Gualtierotti; Giovanni Ferrari Journal: Updates Surg Date: 2021-05-20
Authors: Alireza Ghoreifi; Michael F Basin; Saum Ghodoussipour; Soroush T Bazargani; Erfan Amini; Mohammad Aslzare; Jie Cai; Gus Miranda; Shihab Sugeir; Sumeet Bhanvadia; Anne K Schuckman; Siamak Daneshmand; Philip Lumb; Hooman Djaladat Journal: Int Urol Nephrol Date: 2021-06-04 Impact factor: 2.370
Authors: Frederik König; Benjamin Pradere; Nico C Grossmann; Fahad Quhal; Pawel Rajwa; Ekaterina Laukhtina; Keiichiro Mori; Satoshi Katayama; Takafumi Yanagisawa; Hadi Mostafai; Reza Sari Motlagh; Abdulmajeed Aydh; Roland Dahlem; Shahrokh F Shariat; Michael Rink Journal: Transl Cancer Res Date: 2022-04 Impact factor: 1.241
Authors: Satoshi Katayama; Keiichiro Mori; Benjamin Pradere; Hadi Mostafaei; Victor M Schuettfort; Fahad Quhal; Reza Sari Motlagh; Ekaterina Laukhtina; Marco Moschini; Nico C Grossmann; Yasutomo Nasu; Shahrokh F Shariat; Harun Fajkovic Journal: Int J Clin Oncol Date: 2021-06-19 Impact factor: 3.402