Jordan M Rich, Evan B Garden, Juan Sebastian Arroyave, Yuval Elkun, Daniel Ranti, John L Pfail, Rebecca Klahr, Olamide O Omidele, Victoria Adams-Sommer, Gopi Patel, Sarah Hall Schaefer, Conner Brown, Ketan Badani, Etienne Lavallee, Reza Mehrazin, Kyrollis Attalla, Nikhil Waingankar, Peter Wiklund, John P Sfakianos
BACKGROUND: Enhanced recovery after surgery (ERAS) has significantly decreased the morbidity associated with radical cystectomy. However, infectious complications including sepsis, urinary tract (UTIs), wound (WIs), and intra-abdominal (AIs) infections remain common. OBJECTIVE: To assess whether intracorporeal urinary diversion (ICUD) and antibiogram-directed antimicrobial prophylaxis would decrease infections after robotic-assisted radical cystectomy (RARC). DESIGN, SETTING, AND PARTICIPANTS: A retrospective analysis was performed of a prospectively maintained database of patients undergoing RARC between 2014 and 2022 at a tertiary care institution, identifying two groups based on adherence to a prospectively implemented modified ERAS protocol for RARC: modified-ERAS-ICUD and antibiogram-directed ampicillin-sulbactam, gentamicin, and fluconazole prophylaxis were utilized (from January 2019 to present time), and unmodified-ERAS-extracorporeal urinary diversion (UD) and guideline-recommended cephalosporin-based prophylaxis regimen were utilized (from November 2014 to June 2018)...
October 12, 2023: European Urology Focus