Background
Radical cystectomy (RC) is marked by a tremendous potential for short and long-term complications. By introduction of Enhanced Recovery After Surgery (ERAS) protocols serious endeavors have been made in order to reduce postoperative morbidity in favor of a fast-track recovery. In this study, we investigated the impact of our in-house ERAS protocol on postoperative complications and hospital stay.
Methods
We identified 106 patients who received standard care of treatment post-surgery (non-ERAS group). After implementation of our ERAS protocol, we prospectively recorded data from 53 patients (ERAS group) up to 90 days post-surgery. Non-ERAS patients were matched with ERAS patients with respect to preoperative clinical characteristics. Statistical analysis was conducted by matched-pair analysis and Wilcoxon-Mann-Whitney-Test.
Results
Altogether 51 patients were matched. Considering patients with a hospital stay of ≤ 30 and ≤ 20 days we noticed a significant difference in favor of ERAS protocol (p = 0.043, p = 0.004) with regards to hospital stay. Removal of single-J stents occurred on day 11 (8–17) in the non-ERAS group and on day 8 (8–15) in the ERAS group post-surgery (p < 0.001). No difference could be identified in overall and 90-day complication rate (p = 0.443).
Conclusion
Adherence to ERAS protocol achieved a significantly shorter hospital stay in patients with a hospital stay of ≤ 30 and ≤ 20 days with no increase in complication rates. Furthermore, early removal of single-J stents did not result in higher rates of postoperative complications and hospital readmission.