Academic Journal
Optimizing radical cystectomy recovery: The role of modified ERAS in improving postoperative outcomes.
| Τίτλος: | Optimizing radical cystectomy recovery: The role of modified ERAS in improving postoperative outcomes. |
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| Συγγραφείς: | White RE; Vanderbilt Universtiy Medical Center, Department of Urology, Nashville, TN; Maine Health Maine Medical Center Portland, Division of Urology, Portland, ME. Electronic address: Randie.white@vumc.org., Linscott JA; Maine Health Maine Medical Center Portland, Division of Urology, Portland, ME; Moffitt Cancer Center, Urologic Oncology, Tampa, FL., Pelletier C; Maine Health Maine Medical Center Portland, Division of Urology, Portland, ME; University of New England College of Osteopathic Medicine, Portland, ME., Santos E; Maine Health Maine Medical Center Portland, Division of Urology, Portland, ME., James E; Maine Health Maine Medical Center Portland, Division of Urology, Portland, ME., Cole A; Maine Health Maine Medical Center Portland, Division of Urology, Portland, ME., Platteter E; Maine Health Maine Medical Center Portland, Division of Urology, Portland, ME; University of New England College of Osteopathic Medicine, Portland, ME., Howard JM; Maine Health Maine Medical Center Portland, Division of Urology, Portland, ME., Ryan ST; Maine Health Maine Medical Center Portland, Division of Urology, Portland, ME., Hayn MH; Maine Health Maine Medical Center Portland, Division of Urology, Portland, ME., Sammon JD; Maine Health Maine Medical Center Portland, Division of Urology, Portland, ME. |
| Πηγή: | Urologic oncology [Urol Oncol] 2026 Jul; Vol. 44 (7), pp. 316-322. Date of Electronic Publication: 2026 May 08. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: United States NLM ID: 9805460 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-2496 (Electronic) Linking ISSN: 10781439 NLM ISO Abbreviation: Urol Oncol Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2003- : Philadelphia, PA : Elsevier Original Publication: New York, NY : Elsevier Science |
| Ιατρικοί όροι (MeSH): | Cystectomy*/methods , Postoperative Complications*/prevention & control , Urinary Bladder Neoplasms*/surgery , Enhanced Recovery After Surgery*/standards, Humans ; Female ; Male ; Retrospective Studies ; Aged ; Middle Aged ; Treatment Outcome |
| Περίληψη: | Purpose: Radical cystectomy (RC) is associated with high rates of postoperative complications and readmissions. Despite the adoption of enhanced recovery after surgery (ERAS) protocols, there was no reduction in our complications, prompting the development of a modified ERAS (M-ERAS) pathway at our institution. Here, we evaluated the impact of an M-ERAS, featuring tailored antibiotic prophylaxis, earlier stent removal at 2 weeks, and enhanced care coordination, on postoperative outcomes following RC. Methods: We retrospectively reviewed an Internal Review Bord (IRB)-approved database of 306 patients who underwent RC with an ileal conduit between 2015 and 2024. Outcomes from patients treated with the M-ERAS protocol (n = 74) were compared to those from a prior cohort (n = 232). Multivariable logistic regression was used to assess the impact on overall complications, genitourinary (GU) infections, and readmissions at 30 and 90 days. Results: Patient demographics and comorbidities were similar between groups. The proportion of patients experiencing ≥1 complication at 90 days decreased following M-ERAS implementation (78.5% vs. 67.6%). Infectious complications were significantly reduced, driven by a decline in 30-day GU infections (35.3% vs. 12.2%, P ≤ 0.001). Readmissions due to GU infections also decreased at both 30 days (17.7% vs. 4.1%, P = 0.004) and 90 days (7.3% vs. 5.4%, P = 0.324). Adjusted analyses confirmed that M-ERAS was independently protective against GU infections at both 30 and 90 days. Conclusions: A modified ERAS protocol incorporating targeted antibiotic prophylaxis and enhanced perioperative coordination was associated with fewer overall complications and a significant reduction in genitourinary infection-related readmissions after RC. These findings support the use of tailored, procedure-specific recovery pathways to improve outcomes for RC patients. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Cystectomy; Enhanced recovery after surgery; Postoperative complications; Urinary bladder neoplasms; Urinary tract infections |
| Entry Date(s): | Date Created: 20260509 Date Completed: 20260610 Latest Revision: 20260610 |
| Update Code: | 20260611 |
| DOI: | 10.1016/j.urolonc.2026.04.003 |
| PMID: | 42106216 |
| Βάση Δεδομένων: | MEDLINE |
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