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Enhanced Recovery After Surgery for patients undergoing radical cystectomy: Surgeons' perspectives and recommendations ten years after its implementation
S. Albisinni, L. Orecchia, G. Mjaess, F. Aoun, F. Del Giudice, L. Antonelli, M. Moschini, F. Soria, LS. Mertens, A. Gallioli, G. Marcq, B. Pradere, B. Bochner, A. Breda, A. Briganti, J. Catto, K. Decaestecker, P. Gontero, A. Kamat, E. Lambert, A....
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články, systematický přehled, přehledy
- MeSH
- časné pohybování MeSH
- chirurgové MeSH
- cystektomie * metody MeSH
- diverze moči metody MeSH
- lidé MeSH
- nádory močového měchýře chirurgie MeSH
- roboticky asistované výkony MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- urychlená pooperační rehabilitace * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- systematický přehled MeSH
BACKGROUND AND OBJECTIVES: Enhanced Recovery After Surgery (ERAS) guidelines for Radical Cystectomy (RC) were published over ten years ago. Aim of this systematic review is to update ERAS recommendations for patients undergoing RC and to give an expert opinion on the relevance of each single ERAS item. METHODS: A systematic review was performed to identify the impact of each single ERAS item on RC outcomes. Embase and Medline (through Pubmed) were searched systematically. Relevant articles were selected and graded. For each ERAS item, a level of evidence was determined. An e-Delphi consensus was then performed amongst an international panel with renowned experience in RC to provide recommendations based on expert opinion. KEY FINDINGS AND LIMITATIONS: Preoperative medical optimization and avoiding bowel preparation are highly recommended. Robotic-assisted RC with intracorporeal urinary diversion is moderately recommended and can help in applying other ERAS items, such as early mobilization. Medical thromboprophylaxis should be administered and nasogastric tube should be removed at the end of surgery. Perioperative fluid restriction as well as opioid-sparing anesthesia protocols should be implemented. Generally, consensus was reached on most ERAS items, with the exception of epidural anesthesia (no consensus), resection site drainage (consensus against), and type of urinary drainage. Limitations include the lack of a multidisciplinary approach to the present consensus, giving however a highly specialized surgical opinion on ERAS. CONCLUSIONS: and clinical implications: The current study updates ERAS recommendations for patients undergoing RC and suggests application of ERAS by a panel of experts in the field.
Academic Urology Unit University of Sheffield Sheffield UK
Departement of Urology Karl Landsteiner Institute of Urology and Andrology Vienna Austria
Department of Special Surgery Division of Urology The University of Jordan Amman Jordan
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology AZ Maria Middelares Hospital Ghent Belgium Belgium
Department of Urology Claude Huriez Hospital CHU Lille Lille 59037 France
Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Urology Fundació Puigvert Autonoma University of Barcelona Barcelona Spain
Department of Urology Hopital La Croix du Sud Toulouse France
Department of Urology Icahn School of Medicine at Mount Sinai New York NY USA
Department of Urology Kantonsspital Luzern Lucerne Switzerland
Department of Urology Netherlands Cancer Institute Amsterdam the Netherlands
Department of Urology Onze Lieve Vrouwziekenhuis Aalst Belgium
Department of Urology Policlinico Umberto 1 Sapienza University Rome Italy
Department of Urology Rijnstate Hospital 6815 AD Arnhem the Netherlands
Department of Urology University of Texas Southwestern Medical Center Dallas TX USA
Department of Urology UT MD Anderson Cancer Center Houston TX USA
Departments of Urology Weill Cornell Medical College New York NY USA
Faculty of Medicine Hôtel Dieu de France Saint Joseph University Beirut Lebanon
Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK
University of Basel Basel Switzerland
Urology Service Department of Surgery Memorial Sloan Kettering Cancer Center New York NY USA
Citace poskytuje Crossref.org
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