Table 1.
Demographics, surgery and outcome in radical cystectomy patients, before and after the adoption of ERAS protocol without (group 1) and with Alvimopan (group 2)
| Pre-ERAS | Post-ERAS | |||
| Patients | w/Alvimopan | Total | ||
| demographics | Jan 09 – Dec 11 | Jan 12 – Jun 13 | Jul 13 – Dec 14 | Jan 12 – Dec 14 |
| Patients number | 177 | 106 | 101 | 207 |
| Median age | 70 (33–91) | 72 (33–90) | 67 (43–89) | 69 (43–89) |
| Male | 130 (73%) | 83 (78%) | 77 (76%) | 160 (77%) |
| Female | 47 (27%) | 23 (22%) | 24 (24%) | 47 (23%) |
| Median BMI (range) | 27 (14–55) | 27 (19–55) | 26 (18–47) | 27 (19–55) |
| Smoking history | 118 (67%) | 74 (70%) | 70 (70%) | 144 (70%) |
| Charlson comorbidity index: | ||||
| ≤2 | 84 (47%) | 47 (44%) | 47 (46%) | 94 (45%) |
| ≥3 | 93 (53%) | 59 (56%) | 54 (54%) | 113 (54%) |
| Heart disease | 23 (13%) | 21 (19%) | 13 (13%) | 34 (16%) |
| Diabetes | 58 (15%) | 13 (12%) | 14 (14%) | 27 (13%) |
| Cronic kidney insufficiency | 30 (17%) | 37 (35%) | 22 (22%) | 59 (28%) |
| Neoadiuvant chemo | 11 (6%) | 76 (72%) | 54 (54%) | 130 (63%) |
| Prior pelvic radiation | 11 (6%) | 10 (9%) | 4 (4%) | 14 (7%) |
| Prior abdominal surgery | 62 (35%) | 43 (41%) | 37 (37%) | 80 (39%) |
| Surgery | ||||
| Robot assisted | 45 (25%) | 30 (28%) | 1 (1%) | 31 (15%) |
| Diversion type: | ||||
| Ileal conduit | 132 (75%) | 79 (75%) | 51 (51%) | 130 (63%) |
| Orthotopic neobladder | 39 (22%) | 25 (24%) | 46 (46%) | 71 (34%) |
| Continent cutaneous diversion | 6 (3%) | 2 (1%) | 4 (3%) | 6 (3%) |
| Trasfusion (%) | 84 (47%) | 38 (36%) | 51 (51%) | 88 (43%) |
| Tumor stage: | ||||
| T2 or less | 232 (60%) | 64 (60%) | 77 (77%) | 141 (68%) |
| T3, T4 | 75 (42%) | 42 (40%) | 24 (23%) | 66 (32%) |
| Nodal metastasis | 29 (16%) | 24 (23%) | 15 (15%) | 39 (19%) |
| Outcome | ||||
| Median days (range): | ||||
| Ambulation | 3 (1–20) | 2 (1–10) | 2 (1–6) | 2 (1–6) |
| Flatus | 3 (1–13) | 3 (1–8) | 2 (1–7) | |
| Bowel movement | 5 (2–19) | 5 (3–16) | 4 (2–7) | 3 (2–16) |
| Regular diet | 5 (2–36) | 5 (3–17) | 4 (2–7) | 5 (2–17) |
| Hospital stay (range) | 7 (3–78) | 6 (3–27) | 5 (3–36) | 6 (3–36) |
| 30-day readmission | 48 (27%) | 23 (22%) | 18 (18%) | 41 (20%) |
| 90-day readmission | 53 (30%) | 31 (29%) | 25 (25%) | 56 (27%) |
| 90-day mortality | 4 (1%) | 2 (2%) | 1 (1%) | 3 (1%) |
| 90-day minor complications (Clavien 1-2) | 280 (73%) | 79 (75%) | 80 (80%) | 159 (77%) |
| 90-day major complications (Clavien 3–5) | 104 (27%) | 27 (25%) | 21 (20%) | 48 (23%) |