Enhanced recovery after surgery for radical cystectomy with ileal urinary diversion: a multi-institutional, randomized, controlled trial from the Chinese bladder cancer consortium.
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Lin Tianxin, Li Kaiwen, Liu Hao, Xue Xueyi, Xu Ning, Wei Yong, Chen Zhiwen, Zhou Xiaozhou, Qi Lin, He Wei, Tong Shiyu, Jin Fengshuo, Liu Xudong, Wei Qiang, Han Ping, Gou Xin, He Weiyang, Zhang Xu, Yang Guoqiang, Shen Zhoujun, Xu Tianyuan, Xie Xin, Xue Wei, Cao Ming, Yang Jin, Hu Jianyun, Chen Fubao, Li Peijun, Li Guangyong, Xu Tong, Tian Ye, Wang Wenying, Song Dongkui, Shi Lei, Yang Xiaoming, Yang Yang, Shi Benkang, Zhu Yaofeng, Liu Xigao, Xing Jinchun, Wu Zhun, Zhang Kaiyan, Li Wei, Liang Chaozhao, Yang Cheng, Li Wei, Qi Jinchun, Xu Chuanliang, Xu Weidong, Zhou Liqun, Cai Lin, Xu En'ci, Cai Weizhong, Weng Minggao, Su Yiming, Zhou Fangjian, Jiang Lijuan, Liu Zhuowei, Chen Qiuhong, Pan Tiejun, Liu Bo, Zhou Yu, Gao Xin, Qiu Jianguang, Situ Jie, Hu Cheng, Chen Shan, Zheng Yupeng, Huang Jian
Аннотация
METHODS: From October 2014 and July 2016, bladder cancer patients scheduled for curative treatment from 25 centers of Chinese Bladder Cancer Consortium were randomly assigned to either ERAS or CRAS group. Primary endpoint was the 30-day complication rate. Secondary endpoints included recovery of fluid and regular diet, flatus, bowel movement, ambulation, and length of stay (LOS) postoperatively. Follow-up period was 30-day postoperatively.
RESULTS: There were 144 ERAS and 145 CRAS patients. Postoperative complications occurred in 25.7 and 30.3% of the ERAS and CRAS patients with 55 complications in each group, respectively (p = 0.40). There was no significant difference between groups in major complications (p = 0.82), or type of complications (p = 0.99). The ERAS group had faster recovery of bowel movements (median 88 versus 100 h, p = 0.01), fluid diet tolerance (68 versus 96 h, p < 0.001), regular diet tolerance (125 versus 168 h, p = 0.004), and ambulation (64 versus 72 h, p = 0.047) than the CRAS group, but similar time to flatus and LOS.
CONCLUSIONS: ERAS did not increase 30-day complications compared with CRAS after RC. ERAS may be better than CRAS in terms of bowel movement, tolerance of fluid and regular diet, and ambulation.