Presentation Authors: Devanshu Bansal, Brusabhanu Nayak*, Prabhjot Singh, Rishi Nayyar, Amlesh Seth, Rashmi Ramachandran, New Delhi, India
Introduction: Introduction - Radical cystectomy for invasive bladder carcinoma is associated with significant perioperative morbidity. Enhanced recovery after surgery (ERAS) protocols aim to expedite post-operative recovery. There is limited data in the Indian setting regarding the use of ERAS protocol after radical cystectomy. _x000D_
Objective - To evaluate if hospital stay and 30-day perioperative outcomes and complications were improved with implementation of ERAS protocols.
Methods: This prospective randomized controlled trial enrolled 54 patients undergoing open radical cystectomy from April 2017 till May 2018 at a tertiary care centre in India. Follow-up was done till 30-days postoperatively or till discharge, whichever longer._x000D_
Patients in ERAS group received peri-operative care according to ERAS protocol (table 1).Postoperative length of stay, bowel recovery, pain and peri-operative morbidity and mortality data was collected.
Results: 25 Patients in each group were analysed. Length of stay was similar (8 (5-57) vs 9 days (5-19), p-value 0.470). Bowel recovery was significantly faster in ERAS group (12 (12-108) vs 36 hours (12-60) for bowel sounds (p-value 0.001), 60 (12-108) vs 72 hours (36-156) for flatus (p-value 0.001) and 84 (36-180) vs 96 (60-156) for stools (p-value 0.030)). Minor and major 30-day post-operative complications (14 (56%) vs 13 (52%), p-value 0.777) and re-admission (1 (4%) vs 2 (8%), p-value 0.99) were similar. The main limitation of the study was ~72.2% compliance with ERAS protocols. Detailed results in table 2.
Conclusions: Use of ERAS protocols are a viable and possibly preferred option in patients following radical cystectomy and urinary diversion and it enhances post operative recovery.