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Review
. 2020 Mar 17;1(1):5-14.
doi: 10.1002/bco2.9. eCollection 2020 Mar.

Enhanced recovery after surgery review and urology applications in 2020

Rodrigo Rodrigues Pessoa  1 , Ahmet Urkmez  2 , Naveen Kukreja  3 , Janet Baack Kukreja  1
Affiliations
Review

Enhanced recovery after surgery review and urology applications in 2020

Rodrigo Rodrigues Pessoa et al. BJUI Compass. .

Abstract

Purpose: To explore enhanced recovery after surgery (ERAS) components and their current application to major urologic surgeries, barriers to implementation and maintenance of the associated quality improvement. Data Identification: An English language literature search was done using PubMed. Study Selection: After independent review, 55 of the original 214 articles were selected to specifically address the stated purpose. Data Extraction: Clinical trials were included, randomized trials were prioritized, but robust observational studies were also included. Results of Data Synthesis: Many ERAS components have good data to support usage in radical cystectomy (RC) patients. Most ERAS programs include multidisciplinary teams carrying out multimodal pathways to hasten recovery after a major operation. ERAS components generally include preoperative counseling and medical optimization, venous thromboembolism prophylaxis, ileus prevention, avoidance of fluid overload, normothermia maintenance, early mobilization, pain control and early feeding, all leading to early discharge without increased complications or readmissions. Although there may not be specific data pertaining to other major urologic operations, the principles remain similar and ERAS is easily applicable. Conclusion: The benefits of ERAS programs are well established for RC and principles are easily applicable to other major urology operations. Barriers to implantation and maintenance of ERAS must be recognized to continue to maintain the benefits of these programs.

Keywords: enhanced recovery after surgery; fast track; perioperative care; surgical recovery.

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Figures

Figure 1
Figure 1
This is a schematic diagram of enhanced recovery. Important components are divided into preoperative, intraoperative and postoperative categories. VTE, venous thromboembolism; NG, nasogastric; N/V, nausea and vomiting. From Baack Kukreja et al BJUI 2017
See this image and copyright information in PMC

References

    1. Daneshmand S, Ahmadi H, Schuckman AK, Mitra AP, Cai J, Miranda G, et al. Enhanced recovery protocol after radical cystectomy for bladder cancer. J Urol. 2014;192:50–5. - PubMed
    1. Baack Kukreja JE, Kiernan M, Schempp B, Siebert A, Hontar A, Nelson B, et al. Quality improvement in cystectomy care with enhanced recovery (QUICCER) study. BJU Int. 2017;119:38–49. - PubMed
    1. Cerantola Y, Valerio M, Persson B, Jichlinski P, Ljungqvist O, Hubner M, et al. Guidelines for perioperative care after radical cystectomy for bladder cancer: enhanced recovery after surgery (ERAS((R))) society recommendations. Clin Nutr. 2013;32:879–87. - PubMed
    1. Forsmo HM, Pfeffer F, Rasdal A, Sintonen H, Körner H, Erichsen C. Pre‐ and postoperative stoma education and guidance within an enhanced recovery after surgery (ERAS) programme reduces length of hospital stay in colorectal surgery. Int J Surg. 2016;36(Pt A):121–6. - PubMed
    1. Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N, et al. Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS((R))) society recommendations: 2018. World J Surg. 2019;43:659–95. - PubMed

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