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Enhanced recovery cystectomy

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https://www.readbyqxmd.com/read/29784507/in-hospital-length-of-stay-after-major-surgical-oncological-procedures
#1
Sebastiano Nazzani, Felix Preisser, Elio Mazzone, Zhe Tian, Francesco A Mistretta, Shahrokh F Shariat, Fred Saad, Markus Graefen, Derya Tilki, Emanuele Montanari, Stefano Luzzago, Alberto Briganti, Luca Carmignani, Pierre I Karakiewicz
BACKGROUND AND OBJECTIVES: Enhanced recovery after surgery protocols (ERAS) have been developed and implemented as of 2001. However, no previous analyses targeted length of stay (LOS) changes over time after major surgical oncological procedures (MSOPs). METHODS: Between 2003 and 2013, we retrospectively identified patients, who underwent prostatectomy, colectomy, cystectomy, mastectomy, gastrectomy, hysterectomy, nephrectomy, oophorectomy, lung resection or pancreatectomy within the Nationwide Inpatient Sample...
May 9, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29750321/improved-outcomes-of-enhanced-recovery-after-surgery-eras-protocol-for-radical-cystectomy-with-addition-of-a-multidisciplinary-care-process-in-a-us-comprehensive-cancer-care-center
#2
Sephalie Y Patel, Rosemarie E Garcia Getting, Brandon Alford, Karim Hussein, Braydon J Schaible, David Boulware, Jae K Lee, Scott M Gilbert, Julio M Powsang, Wade J Sexton, Philippe E Spiess, Michael A Poch
INTRODUCTION: Although enhanced recovery after surgery (ERAS) components include both anesthesia and surgical care processes, it is unclear whether a multidisciplinary approach to implementing ERAS care processes improves clinical outcomes. The addition of multidisciplinary care with anesthesiology-related components to an existing ERAS protocol for radical cystectomy at a US comprehensive cancer center provided an opportunity to compare short- and long-term outcomes. METHODS: We retrospectively compared the outcomes of 116 consecutive patients who underwent cystectomy after implementation of a multidisciplinary ERAS protocol with those of a historical control group of 143 consecutive patients who had been treated with a surgical ERAS protocol...
May 10, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29732387/transversus-abdominis-plane-blockade-as-part-of-a-multimodal-postoperative-analgesia-plan-in-patients-undergoing-radical-cystectomy
#3
Richard S Matulewicz, Mehul Patel, Brian J Jordan, Jacqueline Morano, Brendan Frainey, Yasin Bhanji, Mahreen Bux, Antoun Nader, Shilajit D Kundu, Joshua J Meeks
Background: Radical cystectomy (RC) is a morbid procedure with frequent complications that may benefit from implementation of an enhanced recovery after surgery (ERAS) protocol. Objective: To examine the benefits of a multimodal analgesic plan that uses continuous transversus abdominis plane (TAP) blockade as part of an ERAS protocol after RC. Methods: A retrospective comparison of consecutive patients undergoing RC over a 4-year period was conducted...
April 26, 2018: Bladder Cancer
https://www.readbyqxmd.com/read/29706465/-do-initial-experience-with-an-enhanced-recovery-program-after-surgery-eras-improve-postoperative-outcomes-after-cystectomy
#4
A Baldini, H Fassi Fehri, Y Cerantola, F Bayle, E Ravier, P Y Belot, N Arnouil, M Colombel, L Badet
OBJECTIVE: To estimate the feasibility and the impact of an ERAS program after radical cystectomy for bladder cancer. MATERIALS AND METHODS: This was a retrospective study comparing a historical pre ERAS group, including all the patients undergoing cystectomy for bladder cancer from January 2013 to December 2015 with a classic procedure, and an interventional ERAS group after introducing an enhanced recovery protocol before, during and after surgery, from February 2016...
April 26, 2018: Progrès en Urologie
https://www.readbyqxmd.com/read/29696301/-radical-cystectomy-and-urinary-diversion-what-is-important
#5
REVIEW
J Noldus, G Niegisch, A Pycha, A Karl
BACKGROUND: In Germany, radical cystectomy with urinary diversion is the primary therapeutic option for localized muscle invasive urothelial bladder cancer. Modifications in the pre-, peri-, and postoperative phase have significantly improved outcomes. OBJECTIVES: Different factors and parameters are directly associated with patients' outcome. An overview on how to best approach this procedure is provided in this article. MATERIALS AND METHODS: The data regarding preparation and the procedure for the radical cystectomy followed by urinary diversion are separately analyzed...
April 25, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29686989/enhanced-recovery-after-surgery-protocols-in-major-urologic-surgery
#6
REVIEW
Natalija Vukovic, Ljubomir Dinic
The purpose of the review: The analysis of the components of enhanced recovery after surgery (ERAS) protocols in urologic surgery. Recent findings: ERAS protocols has been studied for over 20 years in different surgical procedures, mostly in colorectal surgery. The concept of improving patient care and reducing postoperative complications was also applied to major urologic surgery and especially procedure of radical cystectomy. This procedure is technically challenging, due to a major surgical resection and high postoperative complication rate that may reach 65%...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29650138/enhanced-recovery-after-surgery-pathways-role-and-outcomes-in-the-management-of-muscle-invasive-bladder-cancer
#7
REVIEW
Daniel Zainfeld, Ankeet Shah, Siamak Daneshmand
Radical cystectomy remains the gold standard therapy for the treatment of muscle-invasive urothelial carcinoma, yet is accompanied by significant rates of perioperative complications and readmission. Enhanced recovery protocols aim to apply evidence-based principles of care to ameliorate the morbidity of this procedure by enabling better tolerance of and recovery from radical cystectomy. Multiple patient series have demonstrated the capacity for enhanced-recovery-after-surgery (ERAS) principles to improve outcomes among patients undergoing radical cystectomy through decreased incidence of gastrointestinal complications and decreased length of hospitalization without increased readmissions or overall morbidity...
May 2018: Urologic Clinics of North America
https://www.readbyqxmd.com/read/29557251/patient-reported-outcomes-are-associated-with-enhanced-recovery-status-in-patients-with-bladder-cancer-undergoing-radical-cystectomy
#8
Janet Baack Kukreja, Qiuling Shi, Courtney M Chang, Mohamed A Seif, Brandon M Sterling, Ting-Yu Chen, Kelly M Creel, Ashish M Kamat, Colin P Dinney, Neema Navai, Jay B Shah, Xin Shelley Wang
BACKGROUND: Bladder cancer is a disease of the elderly that is associated with high morbidity in those treated with radical cystectomy. In this observational study of patients with bladder cancer undergoing radical cystectomy, we analyzed and compared patient-reported outcomes from those treated with Enhanced Recovery After Surgery (ERAS) methods versus those who received traditional perioperative care. METHODS: We enrolled patients who underwent radical cystectomy at a high-volume tertiary care referral center from November 2013 to December 2016, when the ERAS concept was being introduced into postoperative care at our institution...
June 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29546471/updates-on-robotic-intracorporeal-urinary-diversions
#9
REVIEW
Shawn Dason, Alvin C Goh
PURPOSE OF REVIEW: More than a century of development has led to contemporary urinary diversion. It is paramount that robotic intracorporeal diversions uphold the principles defined by open surgery. RECENT FINDINGS: In this review, we discuss the fundamental open surgical principles that have led to contemporary techniques of urinary diversion. We then outline the technical aspects of several recently described robotic intracorporeal urinary diversions in the context of these surgical principles...
March 15, 2018: Current Urology Reports
https://www.readbyqxmd.com/read/29545042/effect-of-a-radical-cystectomy-care-pathway-on-postoperative-length-of-stay-and-outcomes
#10
John A Brockman, Joel Vetter, Vicky Peck, Seth A Strope
OBJECTIVE: To determine whether an enhance recovery protocol for radical cystectomy patient affected the length of stay or the number and type of readmissions that occurred after hospital discharge. MATERIALS AND METHODS: We prospectively assessed 152 cystectomy patients after initiation of the pathway. These patients were compared with the previous 147 patient operated on before the pathway initiation. Eligible patients were those undergoing radical cystectomy with any diversion at our institution...
March 12, 2018: Urology
https://www.readbyqxmd.com/read/29521264/application-of-eras-enhanced-recovery-after-surgery-and-laparoscopic-surgery-in-the-management-of-patients-with-bladder-cancer
#11
Rafael Uña Orejón, Estrella Mateo Torres, Iván Huercio Martínez, Cristina Jofré Escudero, Juan Gómez Rivas, Jesús Díez Sebastián, Maria Prado Ureta Tolsada
OBJECTIVE: The enhanced recovery after surgery program (ERAS) has become the base of perioperative management in various surgical specialties. However, limited data are available for radical cystectomy. METHODS: We have analyzed 124 patients undergoing radical cystectomy. For retrospective analysis, the patients were divided into two groups:Group A (n=72) included patients whose surgery was performed before the introduction of the ERAS protocol; and Group B (n=52) included patients who were treated following the items included in the ERAS protocol...
March 2018: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/29478962/risk-of-readmission-after-uncomplicated-hospitalization-after-radical-cystectomy
#12
C Adam Lorentz, Kirven Gilbert, Mehrdad Alemozaffar, Dattatraya Patil, Christopher P Filson
BACKGROUND: Enhanced recovery pathways after radical cystectomy attempt to decrease length of hospitalization, but might increase risk of readmission after discharge. We evaluated the relationship between length of stay and readmission after uncomplicated hospitalization for bladder cancer patients treated with radical cystectomy. PATIENTS AND METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program database, we identified bladder cancer patients who were treated with radical cystectomy from 2011 to 2015...
February 2, 2018: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/29454972/enhanced-recovery-after-surgery-pathway-in-patients-undergoing-open-radical-cystectomy-is-safe-and-accelerates-bowel-function-recovery
#13
Vito Palumbo, Gianluca Giannarini, Alessandro Crestani, Marta Rossanese, Mattia Calandriello, Vincenzo Ficarra
OBJECTIVE: To assess whether an Enhanced Recovery After Surgery pathway was associated with a faster bowel function recovery and no increase in morbidity compared with standard perioperative care in a contemporary series of patients undergoing radical cystectomy. METHODS: A prospective single-center single-surgeon cohort of 114 consecutive patients treated with open radical cystectomy between July 2013 and June 2016 was analyzed. A study group of 74 patients with Enhanced Recovery After Surgery pathway was compared with a control group of 40 patients with standard perioperative care...
February 15, 2018: Urology
https://www.readbyqxmd.com/read/29430505/role-of-radical-cystectomy-in-non-organ-confined-bladder-cancer-a-systematic-review
#14
Roger Li, Michael Metcalfe, Janet Kukreja, Neema Navai
Background: Currently, a diagnosis of non-organ confined bladder cancer (NOCBCa) confers a grave prognosis. The mainstay of treatment consists of systemic chemotherapy. However, it must be recognized that NOCBCa is a heterogeneous disease state with important clinical distinctions. While surgical extirpation has traditionally been regarded as overly aggressive for all NOCBCa patients, its utility as part of a multimodal treatment strategy in various clinical scenarios has not been thoroughly investigated...
January 20, 2018: Bladder Cancer
https://www.readbyqxmd.com/read/29299662/the-association-between-intraoperative-fluid-intake-and-postoperative-complications-in-patients-undergoing-radical-cystectomy-with-an-enhanced-recovery-protocol
#15
Soroush T Bazargani, Saum Ghodoussipour, Beverly Tse, Gus Miranda, Jie Cai, Anne Schuckman, Siamak Daneshmand, Hooman Djaladat
PURPOSE: To evaluate the association between intraoperative fluid intake and postoperative complications in patients who underwent radical cystectomy (RC) for bladder cancer with an enhanced recovery protocol. METHODS: 287 patients underwent open RC with enhanced recovery protocol (ERAS) from 2012 to 2016. 107 were excluded; non-urothelial (30), palliative (37), had adjunct procedures or not-consented (40). We prospectively evaluated intraoperative fluid intake (crystalloid, colloid and blood) and correlated with length of stay, 30- and 90-day complications...
March 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29240359/cystectomy-enhanced-recovery-program-nursing-implications
#16
REVIEW
Bettina L Broughton, Barbara Baron, Maureen Kiernan, Janet Baack-Kukreja, Virginia E LaFaro, Rita Larmon, Kay Rust, Bethany A Schempp, Janis Yovanovich
Cystectomy is a complex procedure with a tenuous perioperative course. Enhanced recovery programs (ERPs) are bundle strategies, developed to enhance the recovery of surgical patients. This article outlines the components of an ERP for cystectomy patients from a nursing implementation perspective.
January 2017: Urologic Nursing
https://www.readbyqxmd.com/read/29189517/can-early-oral-prolonged-release-oxycodone-with-or-without-naloxone-reduce-the-duration-of-epidural-analgesia-after-cystectomy-a-3-arm-randomized-double-blind-placebo-controlled-trial
#17
Marc P Schneider, Lukas M Löffel, Marc A Furrer, Fiona C Burkhard, Bettina Kleeb, Michele Curatolo, Patrick Y Wuethrich
Thoracic epidural analgesia (TEA) enhances recovery after bowel surgery. Early postoperative prolonged-release oral formulation of oxycodone or oxycodone/naloxone is potentially useful as a second analgesic step to reduce the duration of TEA. We hypothesized that oxycodone would decrease the duration of TEA and combined with naloxone preserve gastrointestinal function. Ninety patients undergoing open cystectomy and urinary diversion were enrolled in this randomized double-blind, three-arm, parallel-group, placebo-controlled single-center trial between September 2015 and February 2017...
March 2018: Pain
https://www.readbyqxmd.com/read/29167985/short-term-outcome-after-cystectomy-comparison-of-early-oral-feeding-in-an-enhanced-recovery-protocol-and-feeding-using-bengmark-nasojejunal-tube
#18
C S Voskuilen, E E Fransen van de Putte, J Bloos-van der Hulst, E van Werkhoven, W M de Blok, B W G van Rhijn, S Horenblas, R P Meijer
PURPOSE: Cystectomy for bladder cancer is associated with a high risk of postoperative complications. Standardized perioperative protocols, such as enhanced recovery after surgery (ERAS) protocols, aim to improve postoperative outcome. Postoperative feeding strategies are an important part of these protocols. In this two-centre study, we compared complications and length of hospital stay (LOS) between an ERAS protocol with early oral nutrition and a protocol with early enteral feeding with a Bengmark nasojejunal tube...
February 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29152551/bladder-cancer-recovery-pathways-a-systematic-review
#19
Ian Maloney, Daniel C Parker, Michael S Cookson, Sanjay Patel
Background: Enhanced recovery pathways, also known as fast-track protocols, have been adopted since the early 2000s by various surgical specialties with the goal of improving patient outcomes and reducing the cost burden of major surgery on the health care system. Objective: To review the scientific literature on the origin of enhanced recovery pathways, track the contemporary utilization of such practices for patients undergoing radical cystectomy, and analyze the available data regarding their effect on morbidity, mortality, and treatment cost...
October 27, 2017: Bladder Cancer
https://www.readbyqxmd.com/read/29144901/re-quality-improvement-in-cystectomy-care-with-enhanced-recovery-quiccer-study
#20
David S Wang
No abstract text is available yet for this article.
December 2017: Journal of Urology
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