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Although much of the data arise from colorectal surgery, the evidence is applicable to major urological surgery, in particular radical cystectomy. 4 – 8 Despite the significant body of evidence indicating that ERAS protocols lead to improved outcomes, 9, 10 they challenge traditional surgical doctrine, and as a result their implementation has been slow. The key elements of ERAS protocols include preoperative counselling, optimization of nutrition, standardized analgesic and anesthetic regimens and early mobilization. 3Įnhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining pre-operative organ function and reducing the profound stress response following surgery. Overall complication rates have been reported as high as 64% at 90 days, 2 with an average in-patient stay of 17.4 days. 1 Despite improvements in surgical technique, anesthesia and perioperative care, radical cystectomy is still associated with greater morbidity and prolonged in-patient stay after surgery than other urological procedures. ![]() Radical cystectomy with pelvic lymph node dissection remains the standard treatment for patients with muscle invasive bladder cancer. The present article discusses particular aspects of ERAS protocols which represent fundamental shifts in surgical practice, including perioperative nutrition, management of postoperative ileus and the use of mechanical bowel preparation. Despite the significant body of evidence indicating that ERAS protocols lead to improved outcomes, they challenge traditional surgical doctrine, and as a result their implementation has been slow. Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing the profound stress response following surgery. Despite improvements in surgical technique, anesthesia and perioperative care, radical cystectomy is still associated with greater morbidity and prolonged in-patient stay after surgery than other urological procedures. #Fasttrack schedule 10 license key free registration#Registration keys may provide access to different content or features, depending on account permissions.Radical cystectomy with pelvic lymph node dissection remains the standard treatment for patients with muscle invasive bladder cancer. When signing in, users with multiple registration keys for a Thomson Reuters product will have the ability to select which one they would like to begin a session with. What if I have multiple registration keys?
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