Internal audit of an enhanced recovery after surgery protocol for radical cystectomy

Ghodoussipour, Saum; Naser‐Tavakolian, Aurash; Cameron, Brian; Mitra, Anirban P.; Miranda, Gus; Cai, Jie; Bhanvadia, Sumeet; Aron, Monish; Desai, Mihir; Gill, Inderbir S.; Schuckman, Anne; Daneshmand, Siamak; Djaladat, Hooman

doi:10.1007/s00345-020-03135-w

Cited by 13 publications

(7 citation statements)

References 21 publications

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“…The analysis included patients who underwent RC through different approaches (open and robotic), and only one surgeon at our institution routinely performs both. Moreover, as demonstrated in a previously published internal audit from our institution, patients undergoing open RC were more compliant with ERAS protocol than those undergoing robotic RC [ 22 ]. Lastly, several confounding factors that were significant predictors of discharge disposition in other studies, such as frailty and performance status, were not available for inclusion in our analysis.…”

Section: Discussionmentioning

confidence: 79%

“…Readmission was defined as any subsequent inpatient admission or unplanned visit occurring within 30 or 90 days from the day of discharge [ 7 ]. Post-operatively, the patients were managed per our institutional Enhanced Recovery After Surgery (ERAS) protocol as described previously [ 21 ] with some surgeon-specific differences [ 22 ]. Patients were recommended discharge to either home or to a CFR based on detailed physical and occupational therapy evaluation.…”

Section: Methodsmentioning

confidence: 99%

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Impact of Patient, Surgical, and Perioperative Factors on Discharge Disposition after Radical Cystectomy

Cacciamani

Lee

Sanford

et al. 2022

Cancers

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Radical cystectomy (RC) is a complex procedure associated with lengthy hospital stays and high complication and readmission rates. We evaluated the impact of patient, surgical, and perioperative factors on discharge disposition following RC at a tertiary referral center. From 2012 to 2019, all bladder cancer patients undergoing RC at our institution were identified (n = 1153). Patients were classified based on discharge disposition: to home or to continued facility-based rehabilitation centers (CFRs, n = 180 (15.61%) patients). On multivariate analysis of patient factors only, age [Risk Ratio (RR): 1.07, p < 0.001)], single marital status (RR: 1.09, p < 0.001), and living alone prior to surgery (RR: 2.55, p = 0.004) were significant predictors of discharge to CFRs. Multivariate analysis of patient, surgical, and perioperative factors indicated age (RR: 1.09, p < 0.001), single marital status (RR: 3.9, p < 0.001), living alone prior to surgery (RR: 2.42, p = 0.01), and major post-operative (Clavien > 3) complications (RR: 3.44, p < 0.001) were significant independent predictors of discharge to CFRs. Of note, ERAS did not significantly impact discharge disposition. Specific patient and perioperative factors significantly impact discharge disposition. Patients who are older, living alone prior to surgery, and/or have a major post-operative complication are more likely to be discharged to CFRs after RC.

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Section: Discussionmentioning

confidence: 79%

Section: Methodsmentioning

confidence: 99%

Impact of Patient, Surgical, and Perioperative Factors on Discharge Disposition after Radical Cystectomy

Cacciamani

Lee

Sanford

et al. 2022

Cancers

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“…The patient selection process might play a pivotal role in application of the guidelines, as there is greater implementation of the ERAS pathway for younger and healthier patients [9]. Hence, dedication to applying the guidelines, especially for elderly patients, is needed.…”

Section: Discussionmentioning

confidence: 99%

Enhancing Recovery After Major Bladder Cancer Surgery: Comprehensive Review and Assessment of Application of the Enhanced Recovery After Surgery Guidelines

Stangl‐Kremser

Lambertini

Maida

et al. 2022

European Urology Focus

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“…Fast-track surgery (FTS), also known as Enhanced Recovery After Surgery (ERAS), refers to the combination of optimization measures for perioperative treatment with evidence-based medical evidence, and the adoption of an optimized clinical path through multidisciplinary teamwork, in order to reduce the physical and psychological trauma stress of surgical patients, reduce complications and shorten hospital stays, and accelerate the recovery of patients [11]; FTS was first advocated by Danish physician Kehlet [12,13], and has been widely used in countries around the world [14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Without Urinary Catheter During Perioperative Period of Microvascular Decompression of Trigeminal Neuralgia: The Inspiration Under the Concept of Rapid Recovery

Chen¹,

Liu²,

Li³

et al. 2020

AJNS

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Objective: To determine the effect and advantages of no indwelling catheter during perioperative period of microvascular decompression for trigeminal neuralgia under the concept of rapid recovery. Methods: 30 patients underwent microvascular decompression for trigeminal neuralgia at our hospital during February 2017 and December 2019 were collected and divided into experimental group and control group by whether patients adopted urinary catheter or not at the concept of rapid recovery. The data of gender, age, operation time, intraoperative blood loss, urine tract infection, incidence of urinary retention, urinary comfort and average postoperative hospital stay were collected and compared. Results: No significant difference in gender, age, operation time, intraoperative blood loss (P > 0.05) between those two groups. The intraoperative fluid infusion and urine output in the control group were significantly higher than those in the experimental group. There was no significant difference in urine tract infection and urinary retention in these two groups (P > 0.05), comfort level (P < 0.05), and no significant difference in the average postoperative hospital stay (P > 0.05). Conclusions: Microvascular decompression for trigeminal neuralgia without urinary catheter during perioperative period under the concept of rapid recovery is feasible and safe, will not increase risk of urinary retention, improve postoperative comfort and shorten average postoperative hospital stay.

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Internal audit of an enhanced recovery after surgery protocol for radical cystectomy

Cited by 13 publications

References 21 publications

Impact of Patient, Surgical, and Perioperative Factors on Discharge Disposition after Radical Cystectomy

Impact of Patient, Surgical, and Perioperative Factors on Discharge Disposition after Radical Cystectomy

Enhancing Recovery After Major Bladder Cancer Surgery: Comprehensive Review and Assessment of Application of the Enhanced Recovery After Surgery Guidelines

Without Urinary Catheter During Perioperative Period of Microvascular Decompression of Trigeminal Neuralgia: The Inspiration Under the Concept of Rapid Recovery

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