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Enhanced Recovery Protocols (ERP) in Robotic Cystectomy Surgery. Review of Current Status and Trends

  • Urosurgery (J Collins, Section Editor)
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Abstract

Open radical cystectomy with pelvic lymphadenectomy and urinary diversion is associated with a high complication rate. Robotic-assisted laparoscopic radical cystectomy is increasingly performed in many urologic surgical departments in an effort to reduce surgical stress and decrease perioperative morbidity. Robotic cystectomy survival studies demonstrate similar oncologic outcomes compared to the open procedure. Enhanced recovery protocols (ERP) after major surgery are multimodal perioperative interventions to reduce surgical stress, complications, and patient convalescence. Evidence for different ERP interventions are currently mainly from colorectal surgery and recently adapted to major urologic operations including cystectomy. Guidelines for perioperative care after open radical cystectomy for bladder cancer were recently published, but these recommendations may differ when considering a robotic approach. Therefore, we look at the current evidence for ERP in both open and robotic radical cystectomy and the potential for improving ERPs in robotic cystectomy by utilizing a totally intracorporeal robotic cystectomy approach. We also present the Karolinska ERP currently utilized in totally intracorporeal robotic cystectomy.

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Dr. Christofer Adding, Dr. Oscar Laurin, Dr. Abolfazl Hosseini, and Dr. N. Peter Wiklund each declare no potential conflicts of interest.

Dr. Justin W. Collins is a section editor for Current Urology Reports.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Department of Urology, Karolinska University Hospital, 171 76, Stockholm, Sweden

    Christofer Adding, Justin W. Collins, Oscar Laurin, Abolfazl Hosseini & N. Peter Wiklund

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  1. Christofer Adding
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Correspondence to Christofer Adding.

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Adding, C., Collins, J.W., Laurin, O. et al. Enhanced Recovery Protocols (ERP) in Robotic Cystectomy Surgery. Review of Current Status and Trends. Curr Urol Rep 16, 32 (2015). https://doi.org/10.1007/s11934-015-0497-7

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