Enhanced recovery after surgery for radical cystectomy with ileal urinary diversion: a multi-institutional, randomized, controlled trial from the Chinese bladder cancer consortium

被引：83

作者：

Lin, Tianxin ^{[1
]}

Li, Kaiwen ^{[1
]}

Liu, Hao ^{[1
]}

Xue, Xueyi ^{[2
]}

Xu, Ning ^{[2
]}

Wei, Yong ^{[2
]}

Chen, Zhiwen ^{[3
]}

Zhou, Xiaozhou ^{[3
]}

Qi, Lin ^{[4
]}

He, Wei ^{[4
]}

Tong, Shiyu ^{[4
]}

Jin, Fengshuo ^{[5
]}

Liu, Xudong ^{[5
]}

Wei, Qiang ^{[6
]}

Han, Ping ^{[6
]}

Gou, Xin ^{[7
]}

He, Weiyang ^{[7
]}

Zhang, Xu ^{[8
]}

Yang, Guoqiang ^{[8
]}

Shen, Zhoujun ^{[9
]}

Xu, Tianyuan ^{[9
]}

Xie, Xin ^{[9
]}

Xue, Wei ^{[10
]}

Cao, Ming ^{[10
]}

Yang, Jin ^{[11
]}

Hu, Jianyun ^{[11
]}

Chen, Fubao ^{[12
]}

Li, Peijun ^{[12
]}

Li, Guangyong ^{[12
]}

Xu, Tong ^{[12
]}

Tian, Ye ^{[13
]}

Wang, Wenying ^{[13
]}

Song, Dongkui ^{[14
]}

Shi, Lei ^{[14
]}

Yang, Xiaoming ^{[14
]}

Yang, Yang ^{[14
]}

Shi, Benkang ^{[15
]}

Zhu, Yaofeng ^{[15
]}

Liu, Xigao ^{[15
]}

Xing, Jinchun ^{[16
]}

Wu, Zhun ^{[16
]}

Zhang, Kaiyan ^{[16
]}

Li, Wei ^{[16
,18
]}

Liang, Chaozhao ^{[17
]}

Yang, Cheng ^{[17
]}

Li, Wei ^{[16
,18
]}

Qi, Jinchun ^{[18
]}

Xu, Chuanliang ^{[19
]}

Xu, Weidong ^{[19
]}

Zhou, Liqun ^{[20
]}

机构：

[1] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Urol, 107 W Yanjiang Rd, Guangzhou 510120, Guangdong, Peoples R China

[2] Fujian Med Univ, Affiliated Hosp 1, Dept Urol, Fuzhou, Fujian, Peoples R China

[3] Third Mil Med Univ, Southwest Hosp, Dept Urol, Chongqing, Peoples R China

[4] Cent South Univ, Xiangya Hosp, Dept Urol, Changsha, Hunan, Peoples R China

[5] Third Mil Med Univ, Affiliated Hosp 3, Dept Urol, Chongqing, Peoples R China

[6] Sichuan Univ, West China Hosp, Dept Urol, Chengdu, Sichuan, Peoples R China

[7] Chongqing Med Univ, Affiliated Hosp 1, Dept Urol, Chongqing, Peoples R China

[8] Chinese Peoples Liberat Army Gen Hosp, Dept Urol, Beijing, Peoples R China

[9] Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Dept Urol, Shanghai, Peoples R China

[10] Shanghai Jiao Tong Univ, Renji Hosp, Sch Med, Dept Urol, Shanghai, Peoples R China

[11] Chengdu Univ, Affiliated Hosp, Dept Urol, Chengdu, Sichuan, Peoples R China

[12] Ningxia Med Univ, Gen Hosp, Dept Urol, Ningxia, Peoples R China

[13] Capital Med Univ, Beijing Friendship Hosp, Dept Urol, Beijing, Peoples R China

[14] Zhengzhou Univ, Affiliated Hosp 1, Dept Urol, Zhengzhou, Henan, Peoples R China

[15] Shandong Univ, Qilu Hosp, Dept Urol, Jinan, Shandong, Peoples R China

[16] Xiamen Univ, Affiliated Hosp 1, Dept Urol, Xiamen, Fujian, Peoples R China

[17] Anhui Med Univ, Affiliated Hosp 1, Dept Urol, Hefei, Anhui, Peoples R China

[18] Hebei Med Univ, Hosp 2, Dept Urol, Shijiazhuang, Hebei, Peoples R China

[19] Second Mil Med Univ, Shanghai Changhai Hosp, Dept Urol, Shanghai, Peoples R China

[20] Peking Univ, Hosp 1, Dept Urol, Beijing, Peoples R China

[21] Fujian Med Univ, Union Hosp, Dept Urol, Fuzhou, Fujian, Peoples R China

[22] Sun Yat Sen Univ, Ctr Canc, Dept Urol, Guangzhou, Guangdong, Peoples R China

[23] Guangzhou Mil Command, Wuhan Gen Hosp, Dept Urol, Wuhan, Hubei, Peoples R China

[24] Sun Yat Sen Univ, Affiliated Hosp 3, Dept Urol, Guangzhou, Guangdong, Peoples R China

[25] Capital Med Univ, Beijing Tongren Hosp, Dept Urol, Beijing, Peoples R China

[26] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Guangdong Prov Key Lab Malignant Tumor Epigenet &, Guangzhou, Guangdong, Peoples R China

来源：

WORLD JOURNAL OF UROLOGY | 2018年 / 36卷 / 01期

基金：

中国国家自然科学基金;

关键词：

Bladder cancer; Cystectomy; Enhanced recovery after surgery; Randomized controlled trial; Urinary diversion; MECHANICAL BOWEL PREPARATION; METAANALYSIS; OUTCOMES; COMPLICATIONS;

D O I：

10.1007/s00345-017-2108-3

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Enhanced recovery after surgery (ERAS) has played an important role in recovery management for radical cystectomy with ileal urinary diversion (RC-IUD). This study is to evaluate ERAS compared with the conventional recovery after surgery (CRAS) for RC-IUD. From October 2014 and July 2016, bladder cancer patients scheduled for curative treatment from 25 centers of Chinese Bladder Cancer Consortium were randomly assigned to either ERAS or CRAS group. Primary endpoint was the 30-day complication rate. Secondary endpoints included recovery of fluid and regular diet, flatus, bowel movement, ambulation, and length of stay (LOS) postoperatively. Follow-up period was 30-day postoperatively. There were 144 ERAS and 145 CRAS patients. Postoperative complications occurred in 25.7 and 30.3% of the ERAS and CRAS patients with 55 complications in each group, respectively (p = 0.40). There was no significant difference between groups in major complications (p = 0.82), or type of complications (p = 0.99). The ERAS group had faster recovery of bowel movements (median 88 versus 100 h, p = 0.01), fluid diet tolerance (68 versus 96 h, p < 0.001), regular diet tolerance (125 versus 168 h, p = 0.004), and ambulation (64 versus 72 h, p = 0.047) than the CRAS group, but similar time to flatus and LOS. ERAS did not increase 30-day complications compared with CRAS after RC. ERAS may be better than CRAS in terms of bowel movement, tolerance of fluid and regular diet, and ambulation.

引用

页码：41 / 50

页数：10

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