Table 1.

An enhanced recovery after surgery for radical cystectomy ± neobladder focusing on reduced bowel preparation and standardized feeding and analgesic regimens

Day before radical cystectomy - Normal breakfast - Admit to hospital - Unrestricted clear fluids - Refer to dietician - Stoma therapist to see patient - Assess social circumstances and refer if needed	Day 3 and 4 - Remove epidural on day 3 - Continue to mobilize and encourage self-care - Light diet as tolerated - Start planning for discharge
Day of radical cystectomy - Clear carbohydrate drinks up to 2 hours before surgery, then nil by mouth - Restart clear fluids as tolerated when in recovery - Start food chart - Epidural analgesia in situ	Day 5, 6 and 7 - Dietician to assess nutritional requirements on day 5 - If a patient is not eating or drinking after 5 to 6 days, but with bowel activity, then start nasogastric feeding - If there is no bowel activity then start total parenteral nutrition
After radical cystectomy: Day 1 - Free fluids as tolerated - Female patients, remove vaginal pack - Mobilize and refer to physiotherapist - Ranitidine 3 times daily intravenously or twice daily orally - Remove drain if draining <50 mL in 24 hours - Flush 20 mL into neobladder, twice hourly for 12 hours and then 4 times hourly	Day 8 - Stents out (no stentogram) Day 10 - Remove clips
Day 2 - Light diet as tolerated - Mobilize and encourage self-care (catheter care/flushing in neobladders, and stoma bag emptying in patients with a conduit)	Day 11 to 14 - Continue as previous and schedule for return to home