Zainfeld Daniel, Shah Ankeet, Daneshmand Siamak
Department of Urology, USC Keck/Norris Comprehensive Cancer Center, 1441 Eastlake Avenue, Suite 7416, Los Angeles, CA 90089, USA.
Department of Urology, USC Keck/Norris Comprehensive Cancer Center, 1441 Eastlake Avenue, Suite 7416, Los Angeles, CA 90089, USA.
Urol Clin North Am. 2018 May;45(2):229-239. doi: 10.1016/j.ucl.2017.12.007.
Radical cystectomy remains the gold standard therapy for the treatment of muscle-invasive urothelial carcinoma, yet is accompanied by significant rates of perioperative complications and readmission. Enhanced recovery protocols aim to apply evidence-based principles of care to ameliorate the morbidity of this procedure by enabling better tolerance of and recovery from radical cystectomy. Multiple patient series have demonstrated the capacity for enhanced-recovery-after-surgery (ERAS) principles to improve outcomes among patients undergoing radical cystectomy through decreased incidence of gastrointestinal complications and decreased length of hospitalization without increased readmissions or overall morbidity. Opportunities remain for adoption of established ERAS principles.
根治性膀胱切除术仍然是治疗肌肉浸润性尿路上皮癌的金标准疗法，但会伴有较高的围手术期并发症发生率和再入院率。加速康复方案旨在应用循证护理原则，通过使患者更好地耐受根治性膀胱切除术并从中恢复，来改善该手术的发病率。多个患者系列研究表明，术后加速康复（ERAS）原则有能力通过降低胃肠道并发症发生率和缩短住院时间，同时不增加再入院率或总体发病率，来改善接受根治性膀胱切除术患者的预后。采用既定的ERAS原则仍有机会。
