Advantages of enhanced recovery after surgery program in robot-assisted radical cystectomy.

Journal: Scientific reports
Published Date: Sep 27, 2023

Abstract

Radical cystectomy is a gold-standard treatment for muscle-invasive bladder cancer. We recently introduced robot-assisted radical cystectomy (RARC) with perioperative enhanced recovery after surgery (ERAS). The medical records of patients with bladder cancer who underwent open radical cystectomy (ORC) or RARC/ERAS at NTT Medical Center Tokyo were retrospectively reviewed to compare the surgical outcomes, hospital stay, and medical costs between groups. Multidisciplinary full ERAS items were provided for the RARC/ERAS group. The median estimated blood losses in the ORC and RARC/ERAS groups were 650 and 100 mL, and the median operative times were 312 and 445 min, respectively. In addition, the median times to liquid food intake in these groups were 6 and 0 days, the median times to first flatus and first defecation were 2 and 1 day, and 3 and 1.5 days, respectively. The rates of postoperative ileus in the ORC and RARC/ERAS groups were 27.5% and 4.5%, and the median postoperative hospital stays was 26.5 and 12 days, respectively. Medical costs excluding surgery were significantly lower in the RARC/ERAS group. In conclusion, RARC/ERAS represents a safe treatment option for muscle-invasive bladder cancer with decreased perioperative complications and lower medical costs.

Authors

  • Masaki Nakamura
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Ibuki Tsuru
    Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan.
  • Taro Izumi
    Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan.
  • Akihiro Ono
    Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan.
  • Yasushi Inoue
    Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan.
  • Yasuko Muraki
    Information System Group, NTT Medical Center Tokyo, Tokyo, Japan.
  • Yumi Yamada
    Critical Pathway Committee, NTT Medical Center Tokyo, Tokyo, Japan.
  • Yuko Tsuji
    Nutrition Department, NTT Medical Center Tokyo, Tokyo, Japan.
  • Junko Watanabe
    a Department of Neurosurgery , Fukuoka University , Fukuoka , Japan.
  • Mutsuko Fujimura
    Nursing Department, NTT Medical Center Tokyo, Tokyo, Japan.
  • Shunsuke Kihara
    Operating Department, NTT Medical Center Tokyo, Tokyo, Japan.
  • Akihiro Naito
    Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
  • Taichi Shiratori
    Department of Urology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
  • Ryo Amakawa
    Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan.
  • Hiroki Inatsu
    Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan.
  • Tadashi Yoshimatsu
    Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan.
  • Masanori Kashiwagi
    Department of Anesthesiology, NTT Medical Center Tokyo, Tokyo, Japan.
  • Akira Fukuda
    Department of Rehabilitation, NTT Medical Center Tokyo, Tokyo, Japan.
  • Teppei Morikawa
    Department of Diagnostic Pathology, NTT Medical Center Tokyo, Tokyo, Japan.
  • Masashi Kusakabe
    Department of Radiology, NTT Medical Center Tokyo, Tokyo, Japan.
  • Motofumi Suzuki
    Department of Urology, Tokyo Teishin Hospital, Chiyoda-ku, Tokyo, Japan.
  • Shuji Kameyama
    Tokyo Healthcare University, Tokyo, Japan.
  • Haruki Kume
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Hongo7-3-1, Bunkyo-ku, Tokyo, Japan.
  • Yoshiyuki Shiga
    Department of Urology, NTT Medical Center Tokyo, 5-9-22, Higashigotanda, Shinagawa-Ku, Tokyo, 141-8625, Japan.

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