Early Urinary Catheter Removal Research Articles

[Expert consensus on anesthesia in Enhanced Recovery after Surgery for esophageal cancer surgery].

Esophageal cancer is one of the common malignant tumors of the digestive system in China. Surgical intervention is a frequently employed method for treating esophageal cancer. However, esophagectomy is a complex surgical procedure with a relatively high incidence of complications and mortality. In recent years, enhanced recovery after surgery (ERAS) as a novel medical concept, has gradually gained acceptance among healthcare professionals and been widely applied. It has also demonstrated significant efficacy in the surgical treatment of esophageal cancer. This article summarizes evidence-based medicine (EMB) in the perioperative period of ERAS for esophageal cancer treatment and formulates a clinical pathway for ERAS in esophageal cancer treatment throughout the perioperative period, aiming to provide guidance for clinical practice. Preoperatively, the following measures are advocated: preoperative education, preoperative nutrition assessment and risk assessment, individualized fasting and fluid restriction, optimal timing of surgery after neoadjuvant therapy, and the establishment of a multidisciplinary team (MDT) collaborative diagnostic and treatment model. Intraoperatively, optimization of anesthesia strategies, maintenance of optimal fluid balance, implementation of protective lung ventilation strategies, prevention of intraoperative hypothermia, and the selection of appropriate surgical techniques are essential. Postoperatively, effective pain management, thrombosis prevention, early mobilization, early removal of nasogastric tubes, drainage tubes, and urinary catheters, prevention of postoperative complications, and proactive enteral nutrition should be emphasized. It is important to note that the ERAS protocol is not static and continues to undergo improvement, with ongoing systematic training and promotion in the hope of wider adoption in more medical centers.

Implementation and achievements of enhanced recovery after surgery program in perioperative management of gastric cancer patients†

Abstract Objective The enhanced recovery after surgery (ERAS) program is less implemented in gastric cancer patients. The purpose of this survey is to investigate the implementation status of ERAS in perioperative period in gastric cancer. Methods This clinical observational study enrolled 329 patients between January 2020 and August 2020 in a single gastric cancer center. The questionnaire consisted of 4 parts: basic information, preoperative status, intraoperative status, and postoperative status of ERAS implementation in gastric cancer surgery. Results In the preoperative period, patients’ education and counseling (100%) were well adopted. Smoking cessation (34.6%), drinking cessation (36.9%), avoidance of preoperative mechanical bowel preparation (24.3%), respiratory function training (11.2%), and administration of carbohydrate-rich drink before surgery (0.6%) were relatively not well adopted. During the operation, maintenance of intraoperative normothermia and fluid management (100%), as well as epidural analgesia (81.5%), were well adopted. Thromboprophylaxis was performed in 133 (40.4%) patients. In the postoperative period, early active mobilization was implemented about 9.5 h, and early ambulation was implemented about 39.5 h, after surgery. A total of 140 (42.5%) patients received prolonged prophylactic antibiotics; 268 (81.5%) patients were provided diet upon gas passage; and 320 (97.3%) patients received intravenous fluid administration more than 5 d after surgery. The practice rate of early removal of urinary catheter (0%) and nasogastric tube (15.5%) was relatively low. A total of 11 (3.3%) patients experienced postoperative complication, and 1 (0.3%) patient received unplanned reoperation. The average costs were ¥59,500, and the average hospital stay was 12 (5, 36) d. Conclusions Standard perioperative management of ERAS program in gastric cancer surgery in China still requires improvement.

Impact of nursing interventions on discharge disposition in patients with postoperative delirium

Abstract Purpose: To identify patient characteristics and perioperative factors associated with non-home patient discharges and the impact of current delirium nursing interventions on discharge disposition, especially non-home dispositions. Methods: A retrospective pilot chart review was conducted using electronic health records from five networked hospitals in the Mountain West region of the US. The sample comprised 75 randomly selected patients aged 65 or older who screened positive for delirium during hospitalization. Relationships between patient characteristics, nursing interventions, and discharge dispositions were analyzed using chi-square tests and logistic regression. Results: Most participants (69.3%) were discharged to non-home facilities. Delayed urinary catheter removal was a significant nursing intervention factor. Patients with delayed urinary catheter removal were at increased risk of being discharged to a non-home setting compared with those with early urinary catheter removal (aOR: 14.11, P = .010). Preoperative hypoalbuminemia and surgery durations exceeding 60 minutes were associated with non-home dispositions. Conclusion: Delayed urinary catheter removal, surgery duration greater than 1 hour, and preoperative hypoalbuminemia increased the likelihood of non-home discharge placement for older adults who experience postoperative delirium.

GLIOMA-07 E.R.A.S. IN NEURO-ONCOLOGY

Abstract BACKGROUND We performed a retrospective study assesses the efficacy and safety of a protocol for the enhanced recovery after surgery for supratentorial gliomas and metastasis.The protocol applied to the Ca' Foncello Hospital in Treviso starts from the recommendations on the subject that the medical literature reported up to December 2018.Briefly, three main sections:1) preoperative functional status evaluation, preoperative oral carbohydrate loading; 2) minimally invasive surgery, scalp incision anesthesia, nonopioid analgesia; 3) early urinary-catheter removal, standing and feeding resumption within 3-4 hours from surgery. METHODS We analyzed data on 28 patients operated on ERAS protocol and compared them to a control group (22 patients). The main clinical variables are: age, ASA and Charlson comorbidity index; times urinary-catether removal, adherence ambulation, taking food by mouth; hospital long of stay (LOS). We also collected studies from 2016 to 2020 describing data about ERAS and craniotomy and we pooled these into a meta-analysis. RESULTS Postoperative pain was significantly lower in the ERAS group (2.47 vs. 3.95, p-value=0.0007)) as long as time to removal of urinary catheter (3.1 vs. 25.0 hours, p-value < 0.001), adherence to ambulation (4 vs. 25 hours, p-value < 0.001), and first oral solid food intake (5.3 hours vs. 23.7 hours, p-value < 0.001). The mean LOS was 2.9 days in the ERAS group and 4.8 days in the control group (p-value < 0.001), and no differences in terms of surgical and medical complications, 30 days readmission rate, and time between surgery and RT were found. Our data are in line with those reported in the literature as highlighted by our meta-analysis, where hospital LOS and moderate to severe postoperative pain rates (> 4 points on NPRS) were significantly lower in ERAS patients. CONCLUSIONS Our protocol for ERAS in neuro-oncology appears to have significant benefits over conventional management: it may accelerate functional recovery and decrease length of stay

Early Urinary Catheter Removal After Colectomy for Colovesical Fistula is Not Associated With Increased Postoperative Complications.

Management of the bladder defect during colectomy for colovesical fistula (CVF) and recommendations for duration of urinary catheter drainage are inconsistent. This study aimed to determine if urinary catheter drainage duration was associated with postoperative complications. Retrospective single institution cohort study of patients undergoing resection for diverticular CVF from 2015 through 2021. Urinary catheter drainage was defined as Early (≤7days postoperative and then subdivided into 1-2days, 3-5days, 6-7days), and Late (>7days postoperative). Primary outcome was a composite measure of postoperative bladder leak, surgical site infection-III, sepsis, reoperation, and postoperative length-of-stay ≥7days. There were 73 patients-64 Early group and 9 Late group. Composite measure between groups (Early 25% vs Late 33.33%, P = .688) was not significantly different. The Late group had more patients with large bladder defects (33.3% vs 7.8%, P = .054), significantly more patients who underwent suture repair (55.6% vs 14.1%, P = .01), and significantly more patients that had an intraoperative pelvic drain (66.7% vs 15.6%, P = .003). After propensity score inverse weighting, the Late group had significantly more cystogram-detected postoperative bladder leaks (P = .002) and ileus (P = .042) than the Early group. There were no bladder leaks or ileus in those who had urinary catheter removal on postoperative days 1-2. Early urinary catheter removal was associated with no increase in bladder leaks and fewer postoperative complications after definitive management of CVF. Further investigation is required to determine if intraoperative bladder leak testing and postoperative cystograms are useful adjuncts in decision making.

Immediate urinary catheter removal after colorectal surgery with the enhanced recovery after surgery protocol.

The Enhanced Recovery After Surgery protocol for colorectal surgery recommends early urinary catheter (UC) removal after surgery. However, the optimal timing remains controversial. We aimed to evaluate the safety of immediate UC removal and risk factors of postoperative urinary retention (POUR) after colorectal cancer surgery. From November 2019 and April 2022, patients who underwent elective colorectal cancer surgery at Seoul St. Mary's hospital were collected retrospectively. A UC was inserted in the operating room after general anesthesia and removed in the operating room immediately after surgery. The primary outcome was the occurrence of POUR following immediate UC removal after surgery, and the secondary outcomes were the identification of POUR-related risk factors and postoperative complications. Among 737 patients, 81 (10%) had POUR immediately after UC removal. No patient had urinary tract infection. The incidence of POUR was significantly higher in male and in those with a history of urinary disease. However, there were no significant differences in tumor location, surgical procedure, or approach. The mean operative time was significantly longer in the POUR group. Postoperative morbidity and mortality rates did not differ significantly between two groups. Multivariate analysis showed that risk factors for POUR were male, a history of urinary disease, and intrathecal morphine injection. Immediate removal of UC immediately after colorectal surgery is safe and feasible in the trend of ERAS. Male, ahistory of benign prostatic hyperplasia, and intrathecal morphine injection were risk factors for POUR.

Kritički osvrt na koncept ubrzanog oporavka nakon operacije u vaskularnoj hirurgiji - ERAS protokol u vaskularnoj hirurgiji

The concept of enhanced recovery after surgery (Enhanced Recovery After Surgery-ERAS) represents a multimodal approach to surgical treatment of patients, based on evidence, starting preoperatively and continuing postoperatively. The concept aims to improve patient recovery while reducing complications and reducing length of hospital stay. The ERAS concept has become the standard of care in colorectal surgery. It is also used in vascular surgery, especially aortic and carotid surgery. In 2022, the Society for Vascular Surgery and the ERAS Society published the latest recommendations for vascular surgery for patients undergoing open aortic surgery. The study included 590 abstracts. The recommendations refer to the period before the admission of the patient, as well as to the preoperative, intraoperative and postoperative period. Among the most important recommendations are the introduction of preoperative patient education, screening of anemia and nutritional status, optimization of risk factors, reduction of the use of nasogastric tubes and drainage, use of multimodal analgesia, targeted replacement of fluid, early removal of urinary catheters, active and early mobilization, and early enteral nutrition. There is more and more evidence about the importance of the ERAS protocol in elective vascular surgery, as well as its impact on reducing the length of hospital stay, reducing complications and better recovery of patients, lower treatment costs. Its application depends on the medical staff, so the education of healthcare workers is needed in this field.

Impact of early urinary catheter removal on successful voiding and physical function in stroke patients

Impact of early urinary catheter removal on successful voiding and physical function in stroke patients

116: DE-ESCALATING URINARY CATHETER OUTPUT MEASUREMENT REPORTING IN THE ICU: A QUALITATIVE SURVEY

Introduction: Indwelling urinary catheter utilization and catheter-associated urinary tract infection rates remain high among intensive care unit (ICU) patients despite targeted, best practice de-implementation efforts. ICU de-escalation protocols to decrease urinary catheter output measurement reporting could lead to increased urinary catheter removal. As part of our multimodal strategies to advance early urinary catheter removal in select patients, we evaluate attitudes and perceptions of urinary catheter necessity and hourly urine output measurement in the ICU. Methods: We conducted brief qualitative survey at an urban, academic medical center among surgical ICU nurses (RN’s), Advance practice providers (APP), and physicians (MD). Participants selection was random and based on if the patient had a urinary catheter in place. We assessed self-reported perceptions of hourly urine output need as well as perceived barriers toward de-escalation of urinary output measurement reporting (from hourly to q2 or q4hrs) and urinary catheter removal. Results: 51 survey responses were collected in the beginning of the academic calendar. Survey participants were 74.5 percent RN, 7.8 percent APP, and 15.7 percent MD. Most were aware of their ICU urinary catheter removal protocol (52.9%). Participants felt that for a given patient, 74.5% needed hourly urine output monitoring. The most cited indication of hourly urinary catheter measurements was “using urine measure as a marker of perfusion”, “hemodynamic instability”, and “acute kidney injury” (AKI). Missing acute changes related to perfusion or AKI was frequently reported as negative consequence of decreasing urinary catheter output measurement reporting. Being off vasopressors was the most common criteria reported to facilitate acceptance of less frequent urinary catheter output measurement reporting. Resolution of AKI and urinary retention were commonly reported as facilitators for urinary catheter removal. Conclusions: De-escalating urinary catheter output measurement reporting in the ICU is novel. There are notable barriers to this practice that need further exploration to potentially decrease urinary catheter utilization rates in the ICU.

Immediate versus early (24-hours) urinary catheter removal after elective minimally invasive colonic resection: study protocol for a randomized, multicenter, non-inferiority trial

BackgroundEnhanced Recovery After Surgery (ERAS) represents the standard of care in colorectal surgery. Among ERAS items, early removal of urinary catheter (UC) is considered a key issue, though adherence to this specific item still varies among centers. UC placement allows for monitoring of post-operative urinary output but relates to an increased risk of urinary tract infection (UTI), reduced mobility, and patient’s discomfort. Several studies investigated the role of early UC removal specifically looking at the rate of acute urinary retention (AUR) but most of them were retrospective, single-center, underpowered, cohort studies. The main purpose of this study is to compare the rate of AUR after immediate (at the end of the surgery) versus early (within 24 h from the completion of surgery) removal of UC in patients undergoing minimally invasive colonic resection (MICR). The secondary outcomes focus on goals that could be positively impacted by the immediate removal of the UC at the end of the surgery. In particular, the rate of UTIs, perception of pain, time-to-return of bowel and physical functions, postoperative complications, and length of hospital stay will be measured.MethodsThis is a prospective, randomized, controlled, two-arm, multi-center, study comparing the rate of AUR after immediate versus early removal of UC in patients undergoing MICR. The investigators hypothesize that immediate UC removal is non-inferior to 24-h UC removal in terms of AUR rate. Randomization is at the patient level and participants are randomized 1:1 to remove their UC either immediately or within 24 h from the completion of surgery. Those eligible for inclusion were patients undergoing any MICR with an anastomosis above the peritoneal reflection. Those patients who need to continue urinary output monitoring after the surgery will be excluded. The number of patients calculated to be enrolled in each group is 108 based on an expected AUR rate of 3% for the 24-h UC removal group and considering acceptable an AUR of 9% for the immediate UC removal group.DiscussionThe demonstration of a non-inferiority of immediate versus 24-h removal of UC would call into question the usefulness of urinary drainage in the setting of MICR.Trial registrationClinicalTrials.gov NCT05249192. Prospectively registered on February 21, 2022.

Overnight removal of urinary indwelling catheter following vaginal prolapse surgery (OVERACT)

ObjectivePelvic organ prolapse is a common condition in women. Adequate timing of urinary catheter removal after vaginal prolapse surgery is essential to reduce post-operative morbidity. We compared midnight removal of the indwelling urinary catheter to removal next morning. MethodsWe performed a retrospective cohort study among 266 women undergoing vaginal prolapse surgery, of whom 132 women had urinary catheter removal at midnight and 134 women morning after surgery. We compared the occurrence of urinary retention, time till first micturition, need for clean intermittent catherization and duration of hospital admission. Also, we assessed risk factors for the occurrence of retention. ResultsRetention occurred less after midnight removal of the urinary catheter, compared to removal next morning (6.1 % versus 23.9 %, p < 0.001). Furthermore, the time till catheter removal and discharge from hospital were shorter and the need for clean intermittent catheterization during hospital admission was lower after midnight compared to next morning removal of the urinary catheter. We identified anterior colporrhaphy as a risk factor for retention. ConclusionOur results suggest that early removal of the indwelling urinary catheter after vaginal prolapse surgery seems save with respect to urinary retention and leads to earlier mobilization and shorter hospital admission.

Postoperative Urinary Catheterization in Children Treated with or without Epidural Analgesia after Orthopedic Surgery: A Retrospective Review of Practice.

Epidural analgesia is effective and an accepted treatment for postoperative pain. Urinary retention is a known complication, but its description is mostly in the adult literature. Management of urinary catheter (UC) placement and removal is an important consideration in children receiving epidural analgesia. This is a single-center, retrospective observational study which examined UC management in children undergoing lower extremity orthopedic surgery under general anesthesia with or without epidural analgesia from January 2019–June 2021. Of 239 children included, epidural analgesia was used in 57 (23.8%). They were significantly younger and had more co-morbidities. In total, 75 UCs were placed in the OR, 9 in the ward, and 7 re-inserted. UC placement in the epidural group was more common (93% vs. 17%, p < 0.001) and remained longer (3 days vs. 1 day, p = 0.01). Among children without intra-operative UC, ward placement was more common in the epidural cohort (60% vs. 1.6%, p = 0.007). OR UC placement and ward re-insertion were more common in children with neuromuscular disease (61% vs. 22%, p < 0.001), (17% vs. 3%, p = 0.001), respectively. Based on these findings, we hypothesize that it is justifiable to routinely place a UC intra-operatively in children who undergo hip or lower extremity surgery and are treated with epidural analgesia, and caution is advised before early UC removal in orthopedic children with NMD.

European Enhanced Recovery After Surgery (ERAS) gynecologic oncology survey: Status of ERAS protocol implementation across Europe.

To acquire a comprehensive assessment of the current status of implementation of Enhanced Recovery After Surgery (ERAS) protocols across Europe. The survey was launched by The European Network of Young Gynecologic Oncologists (ENYGO). A 45-item survey was disseminated online through the European Society of Gynecological Oncology (ESGO) Network database. A total of 116 ESGO centers participated in the survey between December 2020 and June 2021. Overall, 80 (70%) centers reported that ERAS was implemented at their institution: 63% reported a length of stay (LOS) for advanced ovarian cancer surgery between 5 and 7 days; 57 (81%) centers reported a LOS between 2 and 4 days in patients who underwent an early-stage gynecologic cancer surgery. The ERAS items with high reported compliance (>75% "normally-always") included deep vein thrombosis prophylaxis (89%), antibiotic prophylaxis (79%), prevention of hypothermia (55%), and early mobilization (55%). The ERAS items that were poorly adhered to (less than 50%) included early removal of urinary catheter (33%), and avoidance of drains (25%). This survey shows broad implementation of ERAS protocols across Europe; however, a wide variation in adherence to the various ERAS protocol items was reported.

Validation of a scoring system to predict bladder dysfunction after laparoscopic rectal cancer surgery.

A recent trend in urinary catheter managementin patientswho underwent laparoscopic rectal cancer surgery is early removal. However, some patients develop bladder dysfunction and require urinary re-catheterization. In 2016, a scoring system to predict bladder dysfunction after laparoscopic rectal cancer surgery was developed in our institution. The aim of this study was to demonstrate the validity of this scoring system and to determine the suitability of patients for early removal of urinary catheter. A single-center, retrospective study from a prospective database was conducted on 234 patients who underwent elective laparoscopic rectal cancer surgery between January 2016 and December 2019. According to bladder dysfunction predictive score, the urinary catheter was removed on the first postoperative day (low-risk group) and fifth postoperative day (high-risk group). After catheter removal, all patients were managed using in-house protocols. Of 234 patients, 130 (55.6%) were classified as a low-risk group. The overall incidence of bladder dysfunction was 8.5% (11/130) in the low-risk group and 13.5% (14/104) in the high-risk group. The scoring system developed to predict bladder dysfunction showed good overall performance for discriminating between patients suitable or not for early removal of urinary catheter after laparoscopic rectal cancer surgery.

Early versus delayed removal of urinary catheter after Pelvic organ prolapse surgery and vaginal hysterectomy: A systematic review and meta-analysis of randomized controlled trials

Early versus delayed removal of urinary catheter after Pelvic organ prolapse surgery and vaginal hysterectomy: A systematic review and meta-analysis of randomized controlled trials

Effect of Urinary Catheter Removal Time on Satisfaction of Patients After Lower Limb Fracture Surgery: A Clinical Trial

Background and Objectives The patients undergoing lower limb fracture surgery face with several complications and problems. One of these complications is related to use of urinary catheters and their indwelling which may affect the patients’ satisfaction. This study aims to determine the effect of urinary catheter removal time on the satisfaction of patients undergoing lower limb fracture surgery. Subjects and Methods This is a non-randomized clinical trial that was conducted during 2018-2019 in Tehran, Iran. By using a convenience sampling method, 84 patients undergoing lower limb fracture surgery in the orthopedic department of Imam Khomeini and Bank Melli hospitals were selected and divided into three groups of 28: Catheter removal after 24 hours, catheter removal after 48 hours, and catheter removal after 72 hours. The data were collected through self-reporting and interview. 72 hours after catheterization and voluntary urination, they completed a demographic form and a patient satisfaction questionnaire. The gathered data were analyzed by using descriptive and inferential statistics in SPSS software, version 16. Results All three groups showed high satisfaction with their urination and there was no significant difference among the groups (P=0.86). Regarding overall satisfaction, there was a significant difference among three groups (P=0.031), where the overall satisfaction was higher in patients with 24-hour catheterization. Conclusion Early removal of urinary catheters in patients undergoing lower limb fracture surgery is associated with their higher overall satisfaction.

Effect of Early Removal of Urinary Catheter and Early Leaving of Bed on Postoperative Rehabilitation of Cesarean Section Patients under the Concept of Evidence-based Nursing

Effect of Early Removal of Urinary Catheter and Early Leaving of Bed on Postoperative Rehabilitation of Cesarean Section Patients under the Concept of Evidence-based Nursing

Enhanced recovery after surgery protocol versus conventional care in emergency abdominal trauma surgery: a prospective, randomised, controlled study

Background: Since 1990s there has been a defined role of ERAS in elective surgeries, to optimize the peri-operative care, reducing post-operative complications and length of stay and hence, the overall costs. However, there is paucity of literature in its effectiveness in emergency trauma surgeries. The aim of the study was to investigate the feasibility and outcomes of ERAS protocol in emergency abdominal surgery in the setting of trauma.Methods: Institutional IEC approved study. A prospective randomized of 52 patients with abdominal trauma undergoing emergency laprotomy were included in the study and divided into two groups: ERP and conventional group. The ERP included early feeding, early urinary catheter removal, early mobilization/physiotherapy, early intravenous line removal and early optimal oral analgesia. The primary end-points were the length of hospital stay and secondary end-points included complication rate and re-admission rate.Results: The two groups were comparable with regards to age, gender, mechanism of injury and ISS score. Hospital stay was significantly shorter in the ERAS group: 4.67 days verses 13.36 days (p&lt;0.001). There were 15 and 11 complications in the control and study group respectively. When graded as per the Clavien-Dindo classification there was no significant difference in the 2 groups (p=0.306).Conclusions: This study shows that early recovery programs can be successfully implemented with significant shorter hospital stays without any increase in postoperative complications in trauma patients undergoing emergency laparotomy for abdominal trauma.

Adoption of enhanced surgical recovery (ESR) protocol for adult spinal deformity (ASD) surgery decreases in-hospital and 90-day post-operative opioid consumption.

Retrospective observational cohort study of primary adult spinal deformity (ASD) surgery during the transitional period prior to and after the implementation of Enhanced Surgical Recovery (ESR) at a single center. We sought to determine if ESR reduces in-hospital and 90-day post-operative opioid consumption for ASD surgery. We evaluated patients undergoing primary ASD surgery in the transition period prior to (N = 29) and after (N = 56) adoption of ESR, comparing in-hospital and 90-day post-operative opioid consumption. Regression analysis was used to control for confounders including age, number of surgical levels, surgical approach, staged vs same-day surgery, insurance type and pre-op opioid use. Mean age of the cohort was 53years with 57 (60%) females. Regression analysis showed that pre-operative opioid use and number of levels fused were associated with higher in-hospital and 90-day post-operative opioid consumption, while use of ESR was associated with lower in-hospital and 90-day post-operative opioid consumption. Secondary analysis showed that patients on ESR ambulated earlier (0.6days vs 1.1, p = 0.028) and had their urinary catheter removed earlier (2.7days vs 3.9, p = 0.006) compared to non-ESR patients. ESR was associated with a significantly decreased in-hospital and 90-day post-operative opioid consumption and earlier mobilization with earlier urinary catheter removal in patients undergoing primary ASD surgery. These results demonstrate ESR's potential to improve outcomes in ASD perioperative care. 3.

SURG-07. ERAS IN NEURO-ONCOLOGY

Abstract BACKGROUND We performed a retrospective study assesses the efficacy and safety of a protocol for the enhanced clinical recovery of neuro-oncology patients undergoing surgery for supratentorial gliomas and metastasis. The protocol developed and applied to the Ca'Foncello Hospital in Treviso starts from the recommendations on the subject that the medical literature reported up to December 2018. Briefly, three main sections:1) preoperative functional status evaluation, preoperative oral carbohydrate loading; 2) minimally invasive surgery, scalp incision anesthesia, nonopioid analgesia; 3) early urinary-catheter removal, standing and feeding resumption within 3-4 hours from surgery. METHODS We collected and analyzed data on 28 patients operated on ERAS protocol and compared them to a control group (22 patients). The main clinical variables are: Charlson comorbidity index; times urinary-catether removal, adherence ambulation, taking food by mouth; hospital long of stay (LOS). We also collected studies from 2016 to 2020 describing data about ERAS and craniotomy and we pooled these into a meta-analysis. RESULTS Times urinary-catheter removal (3.1 vs 25 hours.), adherence to ambulation (4 vs 25 hours) and taking food by mouth (5.25 vs 23.72 hours) were significantly (p&amp;lt; 0.001) reduced in the ERAS group. Median hospital LOS was 2.85 days in the ERAS group and 4.77 days in the control group (p&amp;lt; 0.001). Our results overlapped those of the literature; the same trend was highlighted by our meta-analysis, with postoperative pain rates and hospital LOS significantly lower in ERAS patients (7.9 vs. 2.9 days, p &amp;lt; 0.001). A further important finding was that elderly patients (≥ 65 years) got the same outcomes as younger ones. CONCLUSIONS Our protocol for ERAS in neuro-oncology appears to have significant benefits over conventional management: it may improve patient outcomes, accelerate functional recovery, decrease length of stay, and enable patients to begin adjuvant chemotherapy and/or radiation in a more expeditious manner.