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- Title
Enhanced recovery after surgery - ERAS, a new multimodal approach in radical cystectomy patients.
- Authors
Olaru, V.; Gingu, C.; Baston, C.; Preda, A.; Domnisor, Liliana; Manea, I.; Voinea, S.; Sinescu, I.
- Abstract
Enhanced recovery after surgery (ERAS) represents a concept first introduced over two decades ago. This concept comprises of a multitude of pre, intra and post operatory measures that have a primordial goal in reducing stress induced by surgery, and starting early mobilization and nutrition for the patient. ERAS protocols were first implemented in colorectal surgery where now studies show level 1 evidence in lowering complication rates and shortening hospital stay. Comparing radical cystectomy with colorectal surgery, several differences that harden the usefulness of ERAS in urologic surgery appear. As in colorectal surgery the ERAS society recommendations for cystectomy patients divide the possible applicable pathways in pre, intra and post operatory items. Even though some elements appear at first glance practically impossible to put into practice for cystectomy patients, as resection site drainage and urinary drainage due to certain morbidity escalation, most of the program's pathways look encouraging and logical due to confirmation studies in colorectal surgery. ERAS protocols represent a new approach in modern urologic surgery. They are based on hard scientific evidence proved in large prospective clinical trials of colorectal surgery and also urologic surgery. Centers and physicians are encouraged to implement this pathway for the better management of patients resulting in a faster recovery, shorter hospital stay, lower costs and improved quality of life, while maintaining an optimal oncologic control.
- Subjects
POSTOPERATIVE period; STRESS management; ADAPTABILITY (Personality)
- Publication
Romanian Journal of Urology, 2015, Vol 14, Issue 2, p5
- ISSN
1223-0650
- Publication type
Article