90-Day complication rate in patients undergoing radical cystectomy with enhanced recovery protocol: a prospective cohort study.

Abstract

To report 90-day complication rates following radical cystectomy (RC) with enhanced recovery after surgery (ERAS) protocol. All consecutive patients who underwent open RC with ERAS protocol from 2012 to 2014 were included. The protocol includes no bowel preparation or NGT, early feeding, predominantly non-narcotic pain management and μ-opioid antagonists. Non-consenting and lost to follow-up patients were excluded. All patients were closely followed up, and 90-day complication (Clavien-Dindo grading), readmission and emergency room (ER) visits were prospectively recorded. One hundred and sixty-nine cases with a median age of 71years were included in the study. 90-Day major and minor complication rates were 24.3 and 53.9%, respectively. The most common complications were infectious and gastrointestinal. The 90-day ER visit rate was 37.9%, whereas the readmission rate was 29.6%. The most common cause of hospital readmission and ER visits was infections. Radical cystectomy and urinary diversion with enhanced recovery protocol is a morbid surgery. The most common complication, cause of ER visit and readmission is yet infections. Further studies on methods to decrease these rates are underway.