Table 1.
Summary of intraoperative elements from published trials of enhanced recovery after surgery (ERAS) protocols for RC.
| Authors | Arumainayagam et al. | Mukhtar et al. | Dutton et al. | Smith et al. | Daneshmand et al. | Persson et al. | Pang et al. |
|---|---|---|---|---|---|---|---|
| Reference/(n) | (28)/(112) | (46)/(77) | (12)/(165) | (57)/(133) | (58)/(110) | (13)/(70) | (14)/(453) |
| Non-ERAS n/ERAS n | 56/56 | 26/51 | 0/165 | 69/37 ERAS 1, 27 ERAS 2 | 0/110 | 39/31 | 60/393 |
| Surgery type | Open RC | Open RC | Open RC | Open RC | Open RC | Open RC | Open and robotic RC (425/28 ptc.) |
| Ileal condui/Neobl./Con.cu.div. | 47/9/0 | 48/3/0 | 131/34/0 | 133/0/0 | 35/70/5 | 52/18/0 | 368/25/0 |
| Antibiotic prophylaxis | Not specified | Not specified | Single dose cefuroxime, metronidazole | Not specified | + Continued for 24 h | + (100% ptc.) | Coamoxiclav24 h in men48 h in women |
| Analgesic method, n (%) | |||||||
| Epidural | + | + | + 25 ptc. | − ERAS 1− ERAS 2 | – | + | – |
| RSC | – | – | +140 ptc. | + ERAS 1+ ERAS 2 | − Subfascial LA | − | + (53% ptc.) |
| Other | − | − | − | − | iv. Acetaminophen | − | − |
| Avoiding of | |||||||
| NGT | Not specified | + | + | + ERAS 1+ ERAS 2 | − | + | + (84% ptc.) |
| Drains | − | + | − | − | − | + (32% ptc.) | Consider omitting pelvic drain |
| Fluid/sodium management | Not specified | + | + (GDFT) | + ERAS 1, ERAS 2 (GDFT) | + Monitored by SV and CVP | Not specified | + (Limited fluid targeted to losses) |
| Intraoperative warming | Not specified | + | + | − | Not specified | + | + |
| Small incisions | Not specified | + | + | Change in surgical technique | Not specified | Not specified | + (83% ptc.) |
| PONV prevention | Metoclopramide from day 1 | + | Metoclopramide, omeprazole | Not specified | Not specified | + (29% ptc.) | Antiemetics as needed |
| MgSO4 replacement | − | − | − | Infusion in ERAS 2 | − | − | − |
RC, radical cystectomy; ptc., patients; Neobl., neobladder; Con.cu.div., continent cutaneous diversion; RSC, rectus sheath catheter; LA, local anesthetics; NGT, nasogastric tube; GDFT, goal directed fluid therapy; SV, stroke volume; CVP, central venous pressure; PONV, postoperative nausea and vomiting.