ERAS for Ambulatory TURBT: Enhancing Bladder Cancer Care (EMBRACE) randomised controlled trial protocol

Abstract

Introduction: Transurethral resection of bladder tumour (TURBT) is one of the more common procedures performed by urologists. It is often described as an 'incision-free' and 'well-tolerated' operation. However, many patients experience distress and discomfort with the procedure. Substantial opportunity exists to improve the TURBT experience. An enhanced recovery after surgery (ERAS) protocol designed by patients with bladder cancer and their providers has been developed.

Methods and analysis: This is a single-centre, randomised controlled trial to investigate the effectiveness of an ERAS protocol compared with usual care in patients with bladder cancer undergoing ambulatory TURBT. The ERAS protocol is composed of preoperative, intraoperative and postoperative components designed to optimise each phase of perioperative care. 100 patients with suspected or known bladder cancer aged ≥18 years undergoing initial or repeat ambulatory TURBT will be enrolled. The change in Quality of Recovery 15 score, a measure of the quality of recovery, between the day of surgery and postoperative day 1 will be compared between the ERAS and control groups.

Ethics and dissemination: The trial has been approved by the Johns Hopkins Institutional Review Board #00392063. Participants will provide informed consent to participate before taking part in the study. Results will be reported in a separate publication.

Trial registration number: NCT05905276.

Keywords: Adult oncology; Bladder disorders; Patient Reported Outcome Measures; UROLOGY; Urological tumours.

Figure 1

Flow chart. DOS, day of surgery; ERAS, enhanced recovery after surgery; MIBC, muscle invasive bladder cancer; MME, morphine milligram equivalent; POD, postoperative day; UTI-SIQ-8, Urinary Tract Infection-Symptom and Impairment Questionnaire; VAS, Visual Analogue Scale.