Changes in contemporary perioperative care in patients undergoing radical cystectomy

180 Changes in contemporary perioperative care in patients undergoing radical cystectomy Oszczudłowski M.1, Skrzypczyk M.1, Szempliński S.1, Sujecki D.1, Dobruch J.2, Borówka A.2 1 Centre of Postgraduate Medical Education, Professor Witold Orłowski Independent Public Clinical Hosp, Dept. of Urology, Warsaw, Poland, 2Centre of Postgraduate Medical Education, European Health Centre, Dept. of Urology, Otwock, Poland INTRODUCTION & OBJECTIVES: Radical cystectomy (RC) is a complex surgical procedure frequently undertaken in patients who are elderly and burdened with comorbidities. These factors increase frequency of postoperative complications and length of recovery. Using the Enhanced Recovery After Surgery program (ERAS) in patients undergoing partial excision of large intestine, reduces the number of postoperative complications and length of hospital stay. There are presumptions that implementation of full ERAS protocol in patients undergoing RC may shorten time of recovery and time of hospitalization. The aim of the present study is to assess a possibility of ERAS program implementation in patients undergoing RC. Comparison of length of hospitalization, time of gastrointestinal motility recovery and time to oral feeding implementation in patients undergoing RC with use of standard care (Group 1), and those in group covered by ERAS program (Group 2). MATERIAL & METHODS: Data of 31 patients who underwent RC in our clinic from November 2013 till February 2015 were analyzed. 22 patients who were operated by the same surgical team were included in the study. 10 patients (Group 1) underwent RC using the standard perioperative care and 12 (Group 2) using ERAS program. In case of 7 patients (6 in Group 1 and 1 in Group 2) transureterocutaneostomy was performed. In case of remaining patients Bricker diversion or orthotopic neobladder were performed. RESULTS: There were no significant differences between both analyzed groups in terms of average patients age and pathological stage of tumor. 4 patients in Group 1 and 2 in Group 2 were assessed as III or IV group according to ASA physical status classification system. The number of days of postoperative hospitalization in Group 2 was on average 7.5 days (5-14 days) and 11.9 days (7-35 days) in Group 1. Return of gastrointestinal motility in Group 2 was observed on average 2.4 days after surgery (1-3days) and in Group 1 after on average 3.2 days (3-5 days). Oral diet was introduced in Group 2 on average 3 days after surgery (2-4 days) and after on average 4.5 days (3-6days) in Group 1. CONCLUSIONS: It is possible to implement the full ERAS protocol in patients undergoing RC. Using the ERAS program may significantly reduce length of hospitalization in those patients. Eur Urol Suppl 2015; 14(6): e1336