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Enhanced recovery after surgery of patients undergoing radical cystectomy for bladder cancer

Radical cystectomy (RC) is the standard treatment for patients diagnosed with muscle invasive bladder cancer, but is associated with significant morbidity and long hospital stays. Enhanced recovery after surgery (ERAS) is based on a variety of interventions during the peri-treatment stage. It is des...

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Autores principales: Sung, Luck Hee, Yuk, Hyeong Dong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7807364/
https://www.ncbi.nlm.nih.gov/pubmed/33457271
http://dx.doi.org/10.21037/tau.2020.03.44
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author Sung, Luck Hee
Yuk, Hyeong Dong
author_facet Sung, Luck Hee
Yuk, Hyeong Dong
author_sort Sung, Luck Hee
collection PubMed
description Radical cystectomy (RC) is the standard treatment for patients diagnosed with muscle invasive bladder cancer, but is associated with significant morbidity and long hospital stays. Enhanced recovery after surgery (ERAS) is based on a variety of interventions during the peri-treatment stage. It is designed to improve morbidity, enhance recovery, and reduce hospital stays after RC. The study provides an overview of the key elements of the ERAS protocol recommended for patients undergoing RC and directions for further research. We have analyzed the rationale for 15 key elements related to the ERAS protocol: preoperative patient counseling and education, preoperative medical optimization and nutrition, mechanical bowel preparation, preoperative fasting and carbohydrate loading, pre-anesthetic medication, thromboembolic prophylaxis, minimally invasive surgical approach, resection-site drainage, preventing intraoperative hypothermia, perioperative fluid management, perioperative analgesia, urinary drainage, prevention of postoperative ileus, nausea and vomiting, early oral feeding, and early mobilization. Several studies have shown that ERAS improves the recovery of RC patients. Evidence suggests that ERAS facilitates the recovery of RC patients. However, additional randomized controlled studies or large prospective studies are needed to demonstrate the effectiveness of ERAS in RC patients.
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spelling pubmed-78073642021-01-15 Enhanced recovery after surgery of patients undergoing radical cystectomy for bladder cancer Sung, Luck Hee Yuk, Hyeong Dong Transl Androl Urol Review Article on Muscle-Invasive Bladder Cancer Radical cystectomy (RC) is the standard treatment for patients diagnosed with muscle invasive bladder cancer, but is associated with significant morbidity and long hospital stays. Enhanced recovery after surgery (ERAS) is based on a variety of interventions during the peri-treatment stage. It is designed to improve morbidity, enhance recovery, and reduce hospital stays after RC. The study provides an overview of the key elements of the ERAS protocol recommended for patients undergoing RC and directions for further research. We have analyzed the rationale for 15 key elements related to the ERAS protocol: preoperative patient counseling and education, preoperative medical optimization and nutrition, mechanical bowel preparation, preoperative fasting and carbohydrate loading, pre-anesthetic medication, thromboembolic prophylaxis, minimally invasive surgical approach, resection-site drainage, preventing intraoperative hypothermia, perioperative fluid management, perioperative analgesia, urinary drainage, prevention of postoperative ileus, nausea and vomiting, early oral feeding, and early mobilization. Several studies have shown that ERAS improves the recovery of RC patients. Evidence suggests that ERAS facilitates the recovery of RC patients. However, additional randomized controlled studies or large prospective studies are needed to demonstrate the effectiveness of ERAS in RC patients. AME Publishing Company 2020-12 /pmc/articles/PMC7807364/ /pubmed/33457271 http://dx.doi.org/10.21037/tau.2020.03.44 Text en 2020 Translational Andrology and Urology. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Article on Muscle-Invasive Bladder Cancer
Sung, Luck Hee
Yuk, Hyeong Dong
Enhanced recovery after surgery of patients undergoing radical cystectomy for bladder cancer
title Enhanced recovery after surgery of patients undergoing radical cystectomy for bladder cancer
title_full Enhanced recovery after surgery of patients undergoing radical cystectomy for bladder cancer
title_fullStr Enhanced recovery after surgery of patients undergoing radical cystectomy for bladder cancer
title_full_unstemmed Enhanced recovery after surgery of patients undergoing radical cystectomy for bladder cancer
title_short Enhanced recovery after surgery of patients undergoing radical cystectomy for bladder cancer
title_sort enhanced recovery after surgery of patients undergoing radical cystectomy for bladder cancer
topic Review Article on Muscle-Invasive Bladder Cancer
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7807364/
https://www.ncbi.nlm.nih.gov/pubmed/33457271
http://dx.doi.org/10.21037/tau.2020.03.44
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