Table 3.
Summary of findings from published randomized control trials using Enhanced Recovery after Surgery (ERAS) protocols for radial cystectomy
| Study | Findings | |||||
|---|---|---|---|---|---|---|
| Length of stay | Complication s | Readmission s | Mortality rates | Time to BM | Other findings | |
| Arumainayagam et al (2008) [34] | Median time significantly shorter for ERAS group by 4 d | No significant difference in total complications between ERAS and control groups (ERAS n = 18; control n = 23) | No significant difference between ERAS and control groups (ERAS n = 3; control n = 5) | No significant difference between ERAS and control groups (each group n = 1) | No significant difference between ERAS and control groups (both groups median = 6 d) | None reported |
| Pruthi et al (2010) [32] | 80% discharged on postoperative days 4–5a | 39%a | 12%a | 0.01%a | M = 2.9 da | Lower rates (by 9%) of nausea and vomiting with empiric metoclopramide use More rapid recovery of bowel function with gum chewing (gum chewing M = 3.2 d, control M = 3.9 d) |
| Maffezzini et al (2012) [20] Mukhtar et al. (2013) [33] | Not reported Median time significantly shorter for ERAS group by 1.1 d | 35.3%a No significant difference between ERAS and control groups (ERAS n = 20; control n = 11) | Not reported 0% both groups | 2.9%a 3 total across groups | Not reported Significantly shorter for ERAS group by 1.3 d | Not reported Mean ICU stay significantly shorter for ERAS group by 1.4 d Time to removal of NG tube significantly shorter for ERAS group by 3.1 d Mean time to removal of IV fluids significantly shorter for ERAS group by 1.3 d Mean time to full oral diet significantly shorter for ERAS group by 1.3 d |
| Saar et al (2012) [56] | No significant difference between ERAS and control groups (ERAS M = 18.0 d; control M = 18.1 d) | No significant difference in total complications between ERAS and control groups (ERAS n = 12; control n = 15) | No significant difference between ERAS and control groups (ERAS = 2%; control = 6%) | ERAS group n = 1 | No significant difference between ERAS and control groups (ERAS M = 2.6 d; control M = 3.1 d) | Mean time to mobilization significantly shorter for ERAS group by 13.7 h Mean time to regular diet significantly shorter for ERAS group by 2.6 d Use of postoperative morphine equivalents significantly less for ERAS group by 35.1 mg Mean time of intra-operative abdominal drainaged significantly shorter for ERAS group by 3.73 d |
| Daneshmand et al (2014) [22] | Median time significantly shorter for ERAS group by 4 d | 72%a | 23%a | 1%a | M = 2 da | Median time to mobilization = 1 da
Median time to regular diet = 2 da Median oral opioid pain medication = 6.4 mg/da |
| Dutton et al (2014) [57] | M = 9.2 da | 50.1%a | 13.94%a | 1.3%a | M = 6 da | Median time to mobilization = 1–2 da |
| Karl et al (2014) [46] | No significant difference in general hospitalization time between groups ICU time significantly shorter for ERAS group by 0.8 d | No significant difference in complications between groups | Not reported | 0% in both groups | No significant difference in time between groups | ERAS group reported significantly better quality of life in most categories upon discharge compared with control group No significant difference in time to mobilization between groups (91% mobile by 3-d postoperatively ) Use of Class 1 and 2 analgesics significantly lower in ERAS group by 10% and 20%, respectively |
BM = bowel movement; ICU = intensive care unit; IV = intravenous; M = median; NGT = nasogastric
tube.
a
All patients received ERAS protocol (no control group).