Cargando…

Enhanced recovery after surgery (ERAS) protocols in patients undergoing radical cystectomy with ileal urinary diversions: A randomized controlled trial

BACKGROUND: Enhanced Recovery After Surgery (ERAS) protocols were introduced in clinical practice to reduce complication rates and hospital stay. We performed a randomized controlled single center study to evaluate perioperative benefits of an adapted ERAS protocol in patients with bladder cancer wh...

Descripción completa

Detalles Bibliográficos
Autores principales: Vlad, Olaru, Catalin, Baston, Mihai, Harza, Adrian, Preda, Manuela, Olaru, Gener, Ismail, Ioanel, Sinescu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337460/
https://www.ncbi.nlm.nih.gov/pubmed/32629682
http://dx.doi.org/10.1097/MD.0000000000020902
_version_ 1783554516058112000
author Vlad, Olaru
Catalin, Baston
Mihai, Harza
Adrian, Preda
Manuela, Olaru
Gener, Ismail
Ioanel, Sinescu
author_facet Vlad, Olaru
Catalin, Baston
Mihai, Harza
Adrian, Preda
Manuela, Olaru
Gener, Ismail
Ioanel, Sinescu
author_sort Vlad, Olaru
collection PubMed
description BACKGROUND: Enhanced Recovery After Surgery (ERAS) protocols were introduced in clinical practice to reduce complication rates and hospital stay. We performed a randomized controlled single center study to evaluate perioperative benefits of an adapted ERAS protocol in patients with bladder cancer who underwent radical cystectomy (RC) and ileal urinary diversions (IUD). MATERIALS AND METHODS: Forty five from 90 consecutive randomized patients were enrolled in an adapted ERAS protocol. Length of stay, diet issues, return of bowel function, readmission rates and complications were examined. RESULTS: Among patients following ERAS protocol, we found a significant reduction in time to first flatus (1 vs 5 days, P < .001), time to first stool (2 vs 5 days, P < .001), time to normal diet (5 vs 6 days, P < .001) and length of stay (16 vs 18 days, P < .001). Also, postoperative ileus at less than 4 days was lower than in non-ERAS patients (15.6% vs 24.4%), but with a marginal trend toward significance (P = .05). Readmission rate was lower in the ERAS group, but the difference did not reach statistical significance. We also found a lower readmission and complication rate in patients with ERAS protocol (6.6% vs 11.1%, P = .23 and 46.6% vs 57.5%, P = .29, respectively). CONCLUSIONS: Implementation of ERAS protocol for patients undergoing RC in our center was associated with a significant reduction in the time to the first flatus, time to the first stool, time to a normal diet, length of hospital stay.
format Online
Article
Text
id pubmed-7337460
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-73374602020-07-14 Enhanced recovery after surgery (ERAS) protocols in patients undergoing radical cystectomy with ileal urinary diversions: A randomized controlled trial Vlad, Olaru Catalin, Baston Mihai, Harza Adrian, Preda Manuela, Olaru Gener, Ismail Ioanel, Sinescu Medicine (Baltimore) 7300 BACKGROUND: Enhanced Recovery After Surgery (ERAS) protocols were introduced in clinical practice to reduce complication rates and hospital stay. We performed a randomized controlled single center study to evaluate perioperative benefits of an adapted ERAS protocol in patients with bladder cancer who underwent radical cystectomy (RC) and ileal urinary diversions (IUD). MATERIALS AND METHODS: Forty five from 90 consecutive randomized patients were enrolled in an adapted ERAS protocol. Length of stay, diet issues, return of bowel function, readmission rates and complications were examined. RESULTS: Among patients following ERAS protocol, we found a significant reduction in time to first flatus (1 vs 5 days, P < .001), time to first stool (2 vs 5 days, P < .001), time to normal diet (5 vs 6 days, P < .001) and length of stay (16 vs 18 days, P < .001). Also, postoperative ileus at less than 4 days was lower than in non-ERAS patients (15.6% vs 24.4%), but with a marginal trend toward significance (P = .05). Readmission rate was lower in the ERAS group, but the difference did not reach statistical significance. We also found a lower readmission and complication rate in patients with ERAS protocol (6.6% vs 11.1%, P = .23 and 46.6% vs 57.5%, P = .29, respectively). CONCLUSIONS: Implementation of ERAS protocol for patients undergoing RC in our center was associated with a significant reduction in the time to the first flatus, time to the first stool, time to a normal diet, length of hospital stay. Wolters Kluwer Health 2020-07-02 /pmc/articles/PMC7337460/ /pubmed/32629682 http://dx.doi.org/10.1097/MD.0000000000020902 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 7300
Vlad, Olaru
Catalin, Baston
Mihai, Harza
Adrian, Preda
Manuela, Olaru
Gener, Ismail
Ioanel, Sinescu
Enhanced recovery after surgery (ERAS) protocols in patients undergoing radical cystectomy with ileal urinary diversions: A randomized controlled trial
title Enhanced recovery after surgery (ERAS) protocols in patients undergoing radical cystectomy with ileal urinary diversions: A randomized controlled trial
title_full Enhanced recovery after surgery (ERAS) protocols in patients undergoing radical cystectomy with ileal urinary diversions: A randomized controlled trial
title_fullStr Enhanced recovery after surgery (ERAS) protocols in patients undergoing radical cystectomy with ileal urinary diversions: A randomized controlled trial
title_full_unstemmed Enhanced recovery after surgery (ERAS) protocols in patients undergoing radical cystectomy with ileal urinary diversions: A randomized controlled trial
title_short Enhanced recovery after surgery (ERAS) protocols in patients undergoing radical cystectomy with ileal urinary diversions: A randomized controlled trial
title_sort enhanced recovery after surgery (eras) protocols in patients undergoing radical cystectomy with ileal urinary diversions: a randomized controlled trial
topic 7300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337460/
https://www.ncbi.nlm.nih.gov/pubmed/32629682
http://dx.doi.org/10.1097/MD.0000000000020902
work_keys_str_mv AT vladolaru enhancedrecoveryaftersurgeryerasprotocolsinpatientsundergoingradicalcystectomywithilealurinarydiversionsarandomizedcontrolledtrial
AT catalinbaston enhancedrecoveryaftersurgeryerasprotocolsinpatientsundergoingradicalcystectomywithilealurinarydiversionsarandomizedcontrolledtrial
AT mihaiharza enhancedrecoveryaftersurgeryerasprotocolsinpatientsundergoingradicalcystectomywithilealurinarydiversionsarandomizedcontrolledtrial
AT adrianpreda enhancedrecoveryaftersurgeryerasprotocolsinpatientsundergoingradicalcystectomywithilealurinarydiversionsarandomizedcontrolledtrial
AT manuelaolaru enhancedrecoveryaftersurgeryerasprotocolsinpatientsundergoingradicalcystectomywithilealurinarydiversionsarandomizedcontrolledtrial
AT generismail enhancedrecoveryaftersurgeryerasprotocolsinpatientsundergoingradicalcystectomywithilealurinarydiversionsarandomizedcontrolledtrial
AT ioanelsinescu enhancedrecoveryaftersurgeryerasprotocolsinpatientsundergoingradicalcystectomywithilealurinarydiversionsarandomizedcontrolledtrial