Back to Search Results

Enhanced recovery after surgery for radical cystectomy with ileal urinary diversion: a multi-institutional, randomized, controlled trial from the Chinese bladder cancer consortium.

Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 W Yanjiang Road, Yuexiu District, Guangzhou, 510120, Guangdong, China. Department of Urology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China. Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing, China. Department of Urology, Xiangya Hospital of Central South University, Changsha, Hunan, China. Department of Urology, The Third Affiliated Hospital, Third Military Medical University, Chongqing, China. Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China. Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Department of Urology, Chinese PLA General Hospital, Beijing, China. Department of Urology, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China. Department of Urology, Renji Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China. Department of Urology, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China. Department of Urology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China. Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China. Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China. Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, China. Department of Urology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China. Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China. Department of Urology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. Department of Urology, Shanghai Changhai Hospital of Second Military Medical University, Shanghai, China. Department of Urology, Peking University First Hospital, Beijing, China. Department of Urology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China. Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China. Department of Urology, Wuhan General Hospital of Guangzhou Military Command, Wuhan, Hubei, China. Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China. Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, China. Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 W Yanjiang Road, Yuexiu District, Guangzhou, 510120, Guangdong, China. urolhj@sina.com. Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China. urolhj@sina.com.

World journal of urology. 2018;(1):41-50
Full text from:

Other resources

Abstract

PURPOSE Enhanced recovery after surgery (ERAS) has played an important role in recovery management for radical cystectomy with ileal urinary diversion (RC-IUD). This study is to evaluate ERAS compared with the conventional recovery after surgery (CRAS) for RC-IUD. METHODS From October 2014 and July 2016, bladder cancer patients scheduled for curative treatment from 25 centers of Chinese Bladder Cancer Consortium were randomly assigned to either ERAS or CRAS group. Primary endpoint was the 30-day complication rate. Secondary endpoints included recovery of fluid and regular diet, flatus, bowel movement, ambulation, and length of stay (LOS) postoperatively. Follow-up period was 30-day postoperatively. RESULTS There were 144 ERAS and 145 CRAS patients. Postoperative complications occurred in 25.7 and 30.3% of the ERAS and CRAS patients with 55 complications in each group, respectively (p = 0.40). There was no significant difference between groups in major complications (p = 0.82), or type of complications (p = 0.99). The ERAS group had faster recovery of bowel movements (median 88 versus 100 h, p = 0.01), fluid diet tolerance (68 versus 96 h, p < 0.001), regular diet tolerance (125 versus 168 h, p = 0.004), and ambulation (64 versus 72 h, p = 0.047) than the CRAS group, but similar time to flatus and LOS. CONCLUSIONS ERAS did not increase 30-day complications compared with CRAS after RC. ERAS may be better than CRAS in terms of bowel movement, tolerance of fluid and regular diet, and ambulation.

Methodological quality

Metadata