Effectiveness of Enhanced Recovery After Surgery Protocols for Robot Assisted Radical Prostatectomy: A Systematic...

Area of Science:

• Urology
• Surgical Oncology
• Perioperative Medicine

Background:

• Enhanced Recovery After Surgery (ERAS) protocols are evidence-based pathways to optimize surgical outcomes.
• ERAS is established for radical cystectomy but less defined for robotic-assisted radical prostatectomy (RARP).
• This study systematically reviews ERAS in RARP to assess its safety and efficacy.

Purpose of the Study:

• To evaluate the impact of ERAS protocols on perioperative outcomes in patients undergoing RARP.
• To compare ERAS protocols against standard care in RARP patients.
• To analyze the effects of ERAS on length of stay, bowel function, and complication rates.

Main Methods:

• Systematic literature search of PubMed, EMBASE, and Cochrane Central Register (PRISMA guidelines).
• Inclusion of studies comparing ERAS/modified ERAS with standard care in RARP patients.
• Random-effects meta-analysis of outcomes including LOS, bowel function, operative time, blood loss, and complications.

Main Results:

• Seven studies (1314 patients) were included; ERAS significantly reduced length of stay (LOS).
• ERAS protocols demonstrated earlier return of bowel function (flatus and defecation).
• No significant differences were found in complication rates, operative time, or blood loss between ERAS and standard care.

Conclusions:

• ERAS protocols enhance short-term postoperative recovery, particularly gastrointestinal function, in RARP patients.
• The clinical benefit of ERAS on LOS may be modest in current practice due to early discharge trends.
• Future research should identify key ERAS components and their value in higher-risk patient groups.