Early experience with implementing enhanced recovery after surgery protocol during robot-assisted radical prostatectomy

Nakamura, Masaki; Muraki, Yasuko; Tsuji, Y; Watanabe, Junko; Okabe, Kei; Yamada, Yoshiyuki; Kashiwagi, Masanori; Kiuchi, Akiko; Izumi, Taro; Tsuru, Ibuki; Ono, Akiko; Amakawa, Ryo; Inatsu, Hiroki; Inoue, Yasushi; Yoshimatsu, Tadashi; Fukuda, Akira; Hayashi, Michio; Matsumoto, Shinya; Komatsu, Takami; Kameyama, Shuji; Kume, Haruki; Shiga, Yoshiyuki

doi:10.21037/asj-23-4

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“…Our ERAS items were provided by a multidisciplinary team composed of urologists, anesthesiologists, physical therapists, registered dietitians, nurses, pharmacists, diabetologists, and clinical care pathway committee members as described elsewhere 27 . The timeline of our ERAS protocol is shown in Fig.…”

Section: Methodsmentioning

confidence: 99%

Advantages of enhanced recovery after surgery program in robot-assisted radical cystectomy

Nakamura,

Tsuru,

Izumi

et al. 2023

Sci Rep

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Radical cystectomy is a gold-standard treatment for muscle-invasive bladder cancer. We recently introduced robot-assisted radical cystectomy (RARC) with perioperative enhanced recovery after surgery (ERAS). The medical records of patients with bladder cancer who underwent open radical cystectomy (ORC) or RARC/ERAS at NTT Medical Center Tokyo were retrospectively reviewed to compare the surgical outcomes, hospital stay, and medical costs between groups. Multidisciplinary full ERAS items were provided for the RARC/ERAS group. The median estimated blood losses in the ORC and RARC/ERAS groups were 650 and 100 mL, and the median operative times were 312 and 445 min, respectively. In addition, the median times to liquid food intake in these groups were 6 and 0 days, the median times to first flatus and first defecation were 2 and 1 day, and 3 and 1.5 days, respectively. The rates of postoperative ileus in the ORC and RARC/ERAS groups were 27.5% and 4.5%, and the median postoperative hospital stays was 26.5 and 12 days, respectively. Medical costs excluding surgery were significantly lower in the RARC/ERAS group. In conclusion, RARC/ERAS represents a safe treatment option for muscle-invasive bladder cancer with decreased perioperative complications and lower medical costs.

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Section: Methodsmentioning

confidence: 99%