Introduction of an Enhanced Recovery Protocol to Reduce Short-Term Complications following Radical Cystectomy and Intestinal Urinary Diversion with Vescica Ileale Padovana Neobladder

Publisher： Karger

E-ISSN： 1423-0399|92|1|35-40

ISSN： 0042-1138

Source： Urologia Internationalis, Vol.92, Iss.1, 2013-09, pp. : 35-40

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Abstract

Objectives: To reduce short-term complications of radical cystectomy (RC) and intestinal urinary diversion with vescica ileale Padovana (VIP) neobladder, we described and assessed an enhanced recovery protocol (ERP) in a series of consecutive patients. Methods: An ERP was introduced focusing on reduced bowel preparation, standardized feeding and analgesic regimens. We analyzed the outcomes with all patients consecutively undergoing RC and VIP neobladder who met the following inclusion criteria: American Society of Anesthesiologists score <3; absence of malnutrition according to the Mini Nutritional Assessment - Short Form criteria; absence of inflammatory bowel diseases. Results: Thirty-one consecutive patients were recruited to undergo our ERP. Mean age of patients was 62.16 years. No patients died due to surgical complications. Nine of 31 patients experienced complications (29.03%), none requiring surgical intervention. According to Clavien grading, all complications were grade <2. Conclusion: The application of our ERP to our patients undergoing RC and VIP neobladder contributed to reduce postoperative morbidity.