[Enhanced Recovery After Surgery (ERAS®) after radical cystectomy-current data]

Area of Science:

• Urology
• Surgical Oncology
• Perioperative Medicine

Background:

• Radical cystectomy is a major surgery with significant morbidity and mortality.
• Enhanced Recovery After Surgery (ERAS®) protocols are established in colorectal surgery and adapted for radical cystectomy.
• ERAS® aims to optimize perioperative management and patient recovery.

Purpose of the Study:

• To systematically review the literature and guidelines on ERAS® protocols for radical cystectomy.
• To evaluate the evidence supporting the components of ERAS® in this patient population.

Main Methods:

• Conducted a systemic literature search.
• Evaluated relevant clinical guidelines and evidence.

Main Results:

• Most ERAS® recommendations are extrapolated from abdominal surgery data.
• Limited specific trials (4 RCTs) and guidelines exist for radical cystectomy.
• ERAS® implementation appears to reduce length of stay without increasing complications.
• Key components include: no bowel preparation, no nasogastric tube, optimized fluid management, multimodal pain control, early mobilization, and early oral diet.

Conclusions:

• Multidisciplinary collaboration is essential for successful ERAS® implementation.
• Future goals include individualizing ERAS® programs and adapting them to radical cystectomy patients' specific needs.