Volume 73, Issue 3, Pages (March 2018)

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Volume 73, Issue 3, Pages 363-371 (March 2018) Prospective Implementation of Enhanced Recovery After Surgery Protocols to Radical Cystectomy Karl H. Pang, Ruth Groves, Suresh Venugopal, Aidan P. Noon, James W.F. Catto European Urology Volume 73, Issue 3, Pages 363-371 (March 2018) DOI: 10.1016/j.eururo.2017.07.031 Copyright © 2017 European Association of Urology Terms and Conditions

Fig. 1 The use of Enhanced Recovery after Surgery (ERAS) following radical cystectomy. ERAS Components and outcomes are aligned for the 453 consecutive patients. (A) Individual elements from the 26 elements of ERAS are shown for each patient including robotic assisted surgery (RARC), omission of a pelvic drain, the use of oral bowel preparation, same day admission to surgery, regional local anaesthesia (rectus sheath blockade), epidural use, nasogastric tube (NGT), small incision for open surgery, preoperative carbohydrate loading, and designating their pathway as ERAS to facilitate audit. The lower line indicates the extent of ERAS compliance (shades of white [6] to dark grey [10] for use of ERAS). (B) Length of stay (d) and (C) blood loss (ml) across the series are shown as median and interquartile ranges for each 10 consecutive cases. (D) Readmission rates for each 10 consecutive cases across the series. LA=local anaesthetic. European Urology 2018 73, 363-371DOI: (10.1016/j.eururo.2017.07.031) Copyright © 2017 European Association of Urology Terms and Conditions

Fig. 2 Oncological outcomes stratified by the use of Enhanced Recovery after Surgery (ERAS). Within this cohort of 453 patients, there was no difference in (A) pathological lymph node count or (B) margin status or (C) overall survival or (D) bladder cancer specific survival outcomes according to the use of ERAS. European Urology 2018 73, 363-371DOI: (10.1016/j.eururo.2017.07.031) Copyright © 2017 European Association of Urology Terms and Conditions