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Enhanced recovery cystectomy

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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
#1
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...
November 22, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/29152551/bladder-cancer-recovery-pathways-a-systematic-review
#2
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
#3
David S Wang
No abstract text is available yet for this article.
December 2017: Journal of Urology
https://www.readbyqxmd.com/read/29124853/intracorporeal-robotic-assisted-radical-cystectomy-together-with-an-enhanced-recovery-programme-improves-postoperative-outcomes-by-aggregating-marginal-gains
#4
Wei Shen Tan, Mae-Yen Tan, Benjamin W Lamb, Ashwin Sridhar, Anna Mohammed, Hilary Baker, Senthil Nathan, Timothy Briggs, Melanie Tan, John D Kelly
OBJECTIVE: To assess the cumulative effect of an enhanced recovery after surgery (ERAS) pathway and a minimally invasive RARC with intracorporeal urinary diversion (iRARC) in comparison to open radical cystectomy (ORC) on hospital length of stay (LOS) and perioperative outcomes. MATERIALS & METHODS: Between Feb 2009 and Oct 2017, 304 radical cystectomy cases were performed at a single institution (54 ORC, 250 RARC). Data were prospectively collected. We identified 45 consecutive ORC cases performed without ERAS before the commencement of the RARC programme (Cohort A), 50 consecutive iRARC cases performed without ERAS (Cohort B) and 40 iRARC cases with ERAS (Cohort C)...
November 10, 2017: BJU International
https://www.readbyqxmd.com/read/29116394/a-prospective-randomized-pilot-study-evaluating-an-eras-protocol-versus-a-standard-protocol-for-patients-treated-with-radical-cystectomy-and-urinary-diversion-for-bladder-cancer
#5
Sebastian Karl Frees, Jonathan Aning, Peter Black, Werner Struss, Robert Bell, Claudia Chavez-Munoz, Martin Gleave, Alan I So
PURPOSE: There is a lack of evidence demonstrating the benefits of using enhanced recovery after surgery protocols (ERAS). Here, we propose to use a randomized clinical pilot study to demonstrate the benefits and feasibility of implementing ERAS versus standard protocols (SP) in patients undergoing radical cystectomy (RC) and urinary diversion. METHODS: 27 consecutive patients undergoing RC were included in the study. 12 patients were prospectively randomized to follow an ERAS protocol and 15 patients followed an SP...
November 7, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/29080948/enhanced-recovery-after-surgery-for-radical-cystectomy-with-ileal-urinary-diversion-a-multi-institutional-randomized-controlled-trial-from-the-chinese-bladder-cancer-consortium
#6
Tianxin Lin, Kaiwen Li, Hao Liu, Xueyi Xue, Ning Xu, Yong Wei, Zhiwen Chen, Xiaozhou Zhou, Lin Qi, Wei He, Shiyu Tong, Fengshuo Jin, Xudong Liu, Qiang Wei, Ping Han, Xin Gou, Weiyang He, Xu Zhang, Guoqiang Yang, Zhoujun Shen, Tianyuan Xu, Xin Xie, Wei Xue, Ming Cao, Jin Yang, Jianyun Hu, Fubao Chen, Peijun Li, Guangyong Li, Tong Xu, Ye Tian, Wenying Wang, Dongkui Song, Lei Shi, Xiaoming Yang, Yang Yang, Benkang Shi, Yaofeng Zhu, Xigao Liu, Jinchun Xing, Zhun Wu, Kaiyan Zhang, Wei Li, Chaozhao Liang, Cheng Yang, Wei Li, Jinchun Qi, Chuanliang Xu, Weidong Xu, Liqun Zhou, Lin Cai, En'ci Xu, Weizhong Cai, Minggao Weng, Yiming Su, Fangjian Zhou, Lijuan Jiang, Zhuowei Liu, Qiuhong Chen, Tiejun Pan, Bo Liu, Yu Zhou, Xin Gao, Jianguang Qiu, Jie Situ, Cheng Hu, Shan Chen, Yupeng Zheng, Jian Huang
PURPOSE: Enhanced recovery after surgery (ERAS) has played an important role in recovery management for radical cystectomy with ileal urinary diversion (RC-IUD). This study is to evaluate ERAS compared with the conventional recovery after surgery (CRAS) for RC-IUD. METHODS: From October 2014 and July 2016, bladder cancer patients scheduled for curative treatment from 25 centers of Chinese Bladder Cancer Consortium were randomly assigned to either ERAS or CRAS group...
October 28, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/29032237/hospital-charges-and-length-of-stay-following-radical-cystectomy-in-the-eras-era
#7
Alice Semerjian, Niv Milbar, Max Kates, Michael A Gorin, Hiten D Patel, Heather J Chalfin, Steven M Frank, Christopher L Wu, William W Yang, Deb Hobson, Lindsay Robertson, Elizabeth Wick, Mark P Schoenberg, Phillip M Pierorazio, Michael H Johnson, C J Stimson, Trinity J Bivalacqua
OBJECTIVE: To report our center's experience with Enhanced Recovery after Surgery (ERAS) pathway for radical cystectomy (RC), specifically evaluating complications, LOS, 30- and 90-day readmissions, and hospital charges. Pathways of this type have been shown to decrease length of stay (LOS) and post-operative ileus. However, concerns persist that ERAS is costly and increases readmissions. To date, limited studies have evaluated these concerns. MATERIALS AND METHODS: Our ERAS protocol was implemented for RC in December 2015...
October 12, 2017: Urology
https://www.readbyqxmd.com/read/28994830/surgery-enhanced-recovery-after-cystectomy-cocktails-culture-or-consistency
#8
John S McGrath, Raj S Pruthi
No abstract text is available yet for this article.
November 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28976345/-impact-of-a-goal-directed-therapy-in-the-implementation-of-an-eras-enhanced-recovery-after-surgery-protocol-in-laparoscopic-radical-cystectomy
#9
Rafael Uña Orejón, Ivan Huercio Martinez, Estrella Mateo Torres, Cristina Jofré Escudero, Juan Gomez Rivas, Jesús Diez Sebastián, Maria Prado Ureta Tolsada
OBJECTIVES: The intraoperative goaldirected fluid therapy (GDT) has become the base of perioperative management in the fast-track protocols. This program using technology to estimate cardiac output, with the aim of minimizing splanchnic hypoperfusion. However, there is insufficient evidence to confirm its application in radical laparoscopic cystectomy. METHODS: In a retrospective study, we have included 52 patients that were scheduled for radical cystectomy. In group A (n=32) patients were treated following GDT...
October 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28940448/enhanced-recovery-after-urologic-surgery-current-applications-and-future-directions
#10
REVIEW
Daniel Zainfeld, Hooman Djaladat
Coordinated multidisciplinary perioperative care through enhanced recovery protocols has improved outcomes within urologic surgery. Continued development and refinement of enhanced recovery after surgery (ERAS) pathways will further augment the care of patients undergoing all urologic procedures. Among the challenges, moving forward is identification of barriers to ERAS adoption by providers, maximizing adherence among patients, standardization of ERAS pathways through establishment of evidence-based principles, and application in additional complex urologic procedures beyond radical cystectomy...
October 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28801130/prospective-implementation-of-enhanced-recovery-after-surgery-protocols-to-radical-cystectomy
#11
Karl H Pang, Ruth Groves, Suresh Venugopal, Aidan P Noon, James W F Catto
BACKGROUND: Multimodal enhanced recovery after surgery (ERAS) regimens have improved outcomes from colorectal surgery. OBJECTIVE: We report the application of ERAS to patients undergoing radical cystectomy (RC). DESIGN, SETTING, AND PARTICIPANTS: Prospective collection of outcomes from consecutive patients undergoing RC at a single institution. INTERVENTION: Twenty-six components including prehabilitation exercise, same day admission, carbohydrate fluid loading, targeted intraoperative fluid resuscitation, regional local anaesthesia, cessation of nasogastric tubes, omitting oral bowel preparation, avoiding drain use, early mobilisation, chewing gum use, and audit...
August 8, 2017: European Urology
https://www.readbyqxmd.com/read/28753885/gastrointestinal-complications-following-radical-cystectomy-using-enhanced-recovery-protocol
#12
Soroush T Bazargani, Hooman Djaladat, Hamed Ahmadi, Gus Miranda, Jie Cai, Anne K Schuckman, Siamak Daneshmand
BACKGROUND: The development of enhanced recovery after surgery (ERAS) protocols for patients undergoing radical cystectomy (RC) represents a significant advance in perioperative care. OBJECTIVE: To evaluate gastrointestinal (GI) complications following RC and urinary diversion (UD) using our institutional ERAS protocol. DESIGN, SETTING, AND PARTICIPANTS: We identified 377 consecutive cases of open RC and UD for which our ERAS protocol was used from May 2012 to December 2015...
April 25, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28648412/renal-outcome-after-radical-cystectomy-and-urinary-diversion-performed-with-restrictive-hydration-and-vasopressor-administration-in-the-frame-of-an-enhanced-recovery-program-a-follow-up-study-of-a-randomized-clinical-trial
#13
Fiona Mei Wen Wu, Fiona Burkhard, Filippo Turri, Marc Furrer, Lukas Loeffel, George Thalmann, Patrick Wuethrich
OBJECTIVE: To determine whether a restrictive perioperative fluid management in the context of an enhanced recovery after surgery program for radical cystectomy and urinary diversion affects renal function, as fluid restriction and the use of vasopressors have been linked to impaired tissue perfusion, potentially resulting in renal dysfunction. METHODS: We followed 166 patients initially included in a randomized clinical trial and equally allocated to receive a continuous norepinephrine administration combined with 1ml/kg/h initially, and after cystectomy 3ml/kg/h crystalloid infusion (intervention group, n = 83), or a standard crystalloid infusion of 6ml/kg/h throughout surgery (control group, n = 83)...
June 22, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28634646/the-role-of-robotics-in-the-invasive-management-of-bladder-cancer
#14
REVIEW
Pramit Khetrapal, Wei Shen Tan, Benjamin Lamb, Melanie Tan, Hilary Baker, James Thompson, Ashwin Sridhar, John D Kelly, Tim Briggs
Robot-assisted radical cystectomy (RARC) has been adopted widely in many centres, owed largely to the success of robot-assisted laparoscopic prostatectomy (RALP). It aims to replicate the oncological outcomes of open radical cystectomy (ORC), while providing a shorter recovery period. Despite this, previous RCTs have failed to show a benefit for RARC over ORC. These trials have compared extracorporeal RARC (eRARC) with ORC, which requires a further incision to mobilise the bowel for urinary reconstruction with an open technique...
August 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28469297/advances-in-surgical-management-of-muscle-invasive-bladder-cancer
#15
REVIEW
Janet Baack Kukreja, Jay B Shah
INTRODUCTION: Bladder cancer remains a disease of the elderly with relatively few advances that have improved survival over the last 20 years. Radical cystectomy (RC) has long remained the principal treatment for muscle-invasive bladder cancer (MIBC). METHODS: A literature search of PubMed was performed. The content was reviewed for continuity with the topic of surgical advances in MIBC. Articles and society guidelines were included in this review. RESULTS: Despite the associated morbidity, even in the elderly, RC is still a reasonable option...
April 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28462518/alvimopan-for-recovery-of-bowel-function-after-radical-cystectomy
#16
REVIEW
Shahnaz Sultan, Bernadette Coles, Philipp Dahm
BACKGROUND: Alvimopan is used in abdominal surgery to reduce postoperative ileus in patients undergoing small bowel resections with primary anastomosis. The role and efficacy of alvimopan in patients undergoing radical cystectomy with urinary diversion is not well understood. OBJECTIVES: To assess the effects of alvimopan in the context of enhanced recovery pathways compared to enhanced recovery pathways alone for perioperative bowel dysfunction in patients undergoing radical cystectomy...
May 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28342928/does-implementing-an-enhanced-recovery-after-surgery-protocol-increase-hospital-charges-comparisons-from-a-radical-cystectomy-program-at-a-specialty-cancer-center
#17
Juan Chipollini, Dominic H Tang, Karim Hussein, Sephalie Y Patel, Rosemarie E Garcia-Getting, Julio M Pow-Sang, Scott M Gilbert, Wade J Sexton, Philippe E Spiess, Michael A Poch
OBJECTIVE: To compare perioperative charges induced at the initial phase of a standardized enhanced recovery after surgery (ERAS) program from a tertiary referral center. METHODS: A multidisciplinary ERAS protocol was implemented in our department on July 2015. During the subsequent year, all patients were treated according to this protocol (ERAS group). The patients were compared in terms of real in-hospital charges per surgical episode with a control group consisting of consecutive patients before the start of ERAS...
March 23, 2017: Urology
https://www.readbyqxmd.com/read/28256704/a-comprehensive-guide-to-perioperative-management-and-operative-technique-for-robotic-cystectomy-with-intracorporeal-urinary-diversion
#18
Wei Shen Tan, Benjamin W Lamb, Ashwin Sridhar, Timothy P Briggs, John D Kelly
Robotic-assisted radical cystectomy (RARC) represents an evolution of open radical cystectomy (ORC) with the aim of reducing patient morbidity and improving return to normal function, whilst maintaining oncological equivalence. RARC is gaining popularity, especially in high-volume centres, although there remains a lack of level 1 evidence to demonstrate any superiority of RARC over ORC. All previously reported studies that randomised ORC and RARC have utilised a technique for RARC requiring a conversion to open surgery for urinary diversion...
February 27, 2017: Urologia
https://www.readbyqxmd.com/read/28214097/impact-of-an-enhanced-recovery-after-surgery-programme-in-radical-cystectomy-a-cohort-comparative-study
#19
R Casans-Francés, A T Roberto-Alcácer, A C García-Lecina, M L Ferrer-Ferrer, J Subirá-Ríos, J Guillén-Antón
OBJECTIVE: To evaluate the results of the implementation of an enhanced recovery program (ERAS) for open approach radical cystectomy compared to the historical cohort of the same hospital. MATERIAL AND METHODS: A retrospective analysis of 138 consecutive patients who underwent radical cystectomy with Bricker or Studer ileal derivation (97 historical vs. 41 ERAS). Overall complication rate, Clavien-Dindo stage>2 complications, mortality, hospital and critical care length of stay and readmission rates, as well as need for reoperation, nasogastric intubation, transfusion or parenteral nutrition were compared...
June 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28149935/readmission-rate-and-causes-at-90-day-after-radical-cystectomy-in-patients-on-early-recovery-after-surgery-protocol
#20
Emanuela Altobelli, Maurizio Buscarini, Harcharan S Gill, Eila C Skinner
Background: Radical cystectomy (RC) is associated with high risk of early and late perioperative complications, and readmissions. The Enhanced Recovery After Surgery (ERAS) protocol has been applied to RC showing decreased hospital stay without increased morbidity. Objective: To evaluate the specific causes of hospital readmissions in RC patients treated before and after adoption of an ERAS protocol at our institution. Methods: We retrospectively evaluated the outcome of 207 RC patients on ERAS protocol at the Stanford University Hospital from January 2012 to December 2014...
January 27, 2017: Bladder Cancer
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