Results From the ERAS for Ambulatory TURBT: Enhancing Bladder Cancer Care (EMBRACE) Randomized Controlled Trial

Area of Science:

• Urology
• Surgical Oncology
• Anesthesiology

Background:

• Transurethral resection of bladder tumor (TURBT) is a common procedure for bladder cancer, often associated with patient morbidity.
• Optimizing the recovery process after ambulatory TURBT is crucial for improving patient outcomes and reducing healthcare burdens.

Purpose of the Study:

• To evaluate the impact of an Enhanced Recovery After Surgery (ERAS) protocol on the quality of recovery for patients undergoing ambulatory TURBT.
• To compare the effectiveness of ERAS versus usual care in improving patient recovery metrics.

Main Methods:

• A prospective, single-institution randomized controlled trial involving patients undergoing ambulatory TURBT.
• Patients were randomized to either an ERAS protocol group or a usual care group.
• Primary endpoint was the Quality of Recovery 15 (QoR-15) score; secondary endpoints included UTI-SIQ-8, pain, and incontinence rates.

Main Results:

• The ERAS group demonstrated a significantly higher mean QoR-15 score (137 vs. 125, p<0.001) compared to the usual care group.
• ERAS significantly reduced symptom impairment from urinary tract infections (UTI-SIQ-8: 5.8 vs. 12, p<0.001).
• Patients in the ERAS group experienced less pain, dysuria, and urinary incontinence post-procedure.

Conclusions:

• The implementation of ERAS protocols for ambulatory TURBT leads to a significant improvement in the quality of recovery for bladder cancer patients.
• ERAS is an effective strategy for mitigating post-operative morbidity associated with TURBT.
• This approach enhances patient well-being and recovery following bladder tumor resection.