Reporting Radical Cystectomy Outcomes Following Implementation of Enhanced Recovery After Surgery Protocols: A Systematic Review and Individual Patient Data Meta-analysis

Williams, Stephen B.; Cumberbatch, Marcus; Kamat, Ashish M.; Jubber, Ibrahim; Kerr, Preston; McGrath, John; Djaladat, Hooman; Collins, Justin; Packiam, Vignesh T.; Steinberg, Gary D.; Lee, Eugene; Kassouf, Wassim; Black, Peter C.; Cerantola, Yannick; Catto, James W.F.; Daneshmand, Siamak

doi:10.1016/j.eururo.2020.06.039

Cited by 83 publications

(49 citation statements)

References 46 publications

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“…Previous studies have shown that small infra-umbilical and peritoneal incisions in EPRC surgery could help prevent wound-related complications [35], which is consistent with our data. Additionally, it has been recognized that patients receiving the ERAS program have fewer surgical complications and a shorter hospital stay [36]. At present, we performed ELRC surgery in dozens of patients, and have observed a quick postoperative recovery and a short hospital stay.…”

Section: Discussionmentioning

confidence: 86%

Extraperitoneal Laparoscopic Radical Cystectomy With Preservation of Fertility for the Treatment of Ewing Sarcoma: The First Report of a Reliable Surgical Method

Yang

Zhang

Zhao

et al. 2022

Urology

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Section: Discussionmentioning

confidence: 86%

Extraperitoneal Laparoscopic Radical Cystectomy With Preservation of Fertility for the Treatment of Ewing Sarcoma: The First Report of a Reliable Surgical Method

Yang

Zhang

Zhao

et al. 2022

Urology

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“…Our complications rates are in line with previous literature on this topic in the context of Enhanced Recovery After Surgery (ERAS) pathway, which is aimed at reducing length of stay, perioperative complications and costs. In particular, Williams et al [22] in their systematic review reported minor and major complications of 64% and 14% at 30-day and 53% and 24% at 90-day, respectively.…”

Section: Discussionmentioning

confidence: 99%

Single staff cystectomy in a low-volume center: Oncological outcomes and complications

Baumeister

Galioto

Moschini

et al. 2021

CUAJ

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Introduction: Radical cystectomy (RC) with bilateral pelvic lymph node dissection (PLND) is a complex surgical procedure, associated with substantial perioperative complications. Previous studies suggested reserving it to high-volume centers in order to improve oncological and perioperative outcomes. However, only limited data exist regarding low-volume centers with highly experienced surgeons. We aimed to assess oncological and perioperative outcomes after RC performed by experienced surgeons in the low-volume center of Luzerner Kantonsspital, Lucerne, CH. Methods: We retrospectively analyzed data of 158 patients who underwent RC and PLND performed between 2009 and 2019 at a single low-volume center by three experienced surgeons, each having performed at least 50 RCs. Complications were graded according to the 2004 modified Clavien-Dindo grading system. Results: A total of 110 patients (70%) received an incontinent urinary diversion (ileal conduit or ureterocutaneostomy) and 48 patients (30%) received a continent urinary diversion (ileal orthotopic neobladder, ureterosigmoidostomy, or Mitrofanoff pouch). Median operating time was 419 minutes (interquartile range [IQR] 346–461). Overall, at RC specimen, 71.5% of patients had urothelial carcinoma ,12.6% squamous, 3.1% sarcomatoid, 1.2%glandular, and 0.6% small cell carcinoma. Median number of lymph nodes removed was 23 (IQR 16–29.5). Positive margins were found in eight patients (5.1%). Overall, five-year survival rate was 52.4%. The complication rate was 56.3%: 143 complications were found in 89 patients, 36 (22.8%) with Clavien ≥3. The 30-day mortality rate was 2.5%. Conclusions: RC could be safely performed in a low-volume center by experienced surgeons with comparable outcomes to high-volume centers.

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“…After initial implementation with colorectal surgeons in 2009 with minimally invasive teams, then expanded to the entire Division as a standard of practice for all patients undergoing colorectal surgery in 2011. Next, team members worked to diffuse to Gynecologic surgery [ 60 ], Breast [ 61 ], Urology [ 62 , 63 , 64 ], Endocrine, Hepatobiliary [ 65 , 66 ], Thoracic [ 67 , 68 ] and Vascular [ 69 , 70 ] within one campus of the institution, then continued to expand enterprise-wide knowledge within the same organization while also collaborating with teams at external organizations. The framework of spread was used, and results from network collaboratives shared [ 38 ].…”

Section: Methodsmentioning

confidence: 99%

Enhanced Recovery: A Decade of Experience and Future Prospects at the Mayo Clinic

Lovely

Larson

2021

Healthcare

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This work aims to describe the implementation and subsequent learnings from the first decade after the full implementation of enhanced recovery pathway for colorectal surgery at a single institution. This paper will describe the diffusion efforts and plans through the Define, Measure, Analyze, Improve, Control (DMAIC) process of ongoing quality improvement and through research efforts. The information applies to all readers that provide surgical care within their organization as the fundamental principles of enhanced recovery for surgery are applicable regardless of the setting.

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Reporting Radical Cystectomy Outcomes Following Implementation of Enhanced Recovery After Surgery Protocols: A Systematic Review and Individual Patient Data Meta-analysis

Cited by 83 publications

References 46 publications

Extraperitoneal Laparoscopic Radical Cystectomy With Preservation of Fertility for the Treatment of Ewing Sarcoma: The First Report of a Reliable Surgical Method

Extraperitoneal Laparoscopic Radical Cystectomy With Preservation of Fertility for the Treatment of Ewing Sarcoma: The First Report of a Reliable Surgical Method

Single staff cystectomy in a low-volume center: Oncological outcomes and complications

Enhanced Recovery: A Decade of Experience and Future Prospects at the Mayo Clinic

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