Chenam Avinash, Chan Kevin G
Department of Surgery, Division of Urology and Urologic Oncology, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA.
Cancer Treat Res. 2018;175:215-239. doi: 10.1007/978-3-319-93339-9_10.
Even with advances in perioperative medical care, anesthetic management, and surgical techniques, radical cystectomy (RC) continues to be associated with a high morbidity rate as well as a prolonged length of hospital stay. In recent years, there has been great interest in identifying multimodal and interdisciplinary strategies that help accelerate postoperative convalescence by reducing variation in perioperative care of patients undergoing complex surgeries. Enhanced recovery after surgery (ERAS) attempts to evaluate and incorporate scientific evidence for modifying as many of the factors contributing to the morbidity of RC as possible, and optimize how patients are cared for before and after surgery. In this chapter, we review the preoperative, intraoperative and postoperative elements of using an ERAS protocol for RC.
尽管围手术期医疗护理、麻醉管理和手术技术有所进步,但根治性膀胱切除术(RC)仍然伴随着高发病率以及较长的住院时间。近年来,人们对确定多模式和跨学科策略产生了浓厚兴趣,这些策略有助于通过减少复杂手术患者围手术期护理的差异来加速术后康复。术后加速康复(ERAS)试图评估并纳入科学证据,以尽可能多地改变导致RC发病的因素,并优化患者手术前后的护理方式。在本章中,我们回顾了将ERAS方案用于RC的术前、术中和术后要点。