Enhanced Recovery After Surgery Pathways: Role and Outcomes in the Management of Muscle Invasive Bladder Cancer

Daniel Zainfeld; Ankeet Shah; Siamak Daneshmand

doi:10.1016/j.ucl.2017.12.007

Enhanced Recovery After Surgery Pathways: Role and Outcomes in the Management of Muscle Invasive Bladder Cancer

Urol Clin North Am. 2018 May;45(2):229-239. doi: 10.1016/j.ucl.2017.12.007.

Authors

Daniel Zainfeld¹, Ankeet Shah¹, Siamak Daneshmand²

Affiliations

¹ Department of Urology, USC Keck/Norris Comprehensive Cancer Center, 1441 Eastlake Avenue, Suite 7416, Los Angeles, CA 90089, USA.
² Department of Urology, USC Keck/Norris Comprehensive Cancer Center, 1441 Eastlake Avenue, Suite 7416, Los Angeles, CA 90089, USA. Electronic address: daneshma@med.usc.edu.

PMID: 29650138
DOI: 10.1016/j.ucl.2017.12.007

Abstract

Radical cystectomy remains the gold standard therapy for the treatment of muscle-invasive urothelial carcinoma, yet is accompanied by significant rates of perioperative complications and readmission. Enhanced recovery protocols aim to apply evidence-based principles of care to ameliorate the morbidity of this procedure by enabling better tolerance of and recovery from radical cystectomy. Multiple patient series have demonstrated the capacity for enhanced-recovery-after-surgery (ERAS) principles to improve outcomes among patients undergoing radical cystectomy through decreased incidence of gastrointestinal complications and decreased length of hospitalization without increased readmissions or overall morbidity. Opportunities remain for adoption of established ERAS principles.

Keywords: Bladder cancer; Cystectomy; ERAS; Enhanced recovery; Fast track.

Publication types

Review

MeSH terms

Carcinoma, Transitional Cell / surgery*
Clinical Protocols / standards
Critical Pathways / standards*
Cystectomy / adverse effects
Cystectomy / methods*
Cystectomy / standards
Humans
Urinary Bladder Neoplasms / surgery*