Gastrointestinal Complications in Patients Who Undergo Radical Cystectomy with Enhanced Recovery Protocol

Curr Urol Rep. 2016 Jul;17(7):50. doi: 10.1007/s11934-016-0607-1.

Abstract

Gastrointestinal (GI) complications are among the most common complications following radical cystectomy and urinary diversion. The most common is postoperative ileus, although its precise pathophysiology is not completely understood. Enhanced recovery after surgery (ERAS) protocols include evidence-based steps to optimize postoperative recovery and shorten hospital stay, mainly through expedited GI function recovery. They include avoiding bowel preparation and postoperative nasogastric tube, early feeding, non-narcotic pain management, and the use of cholinergic and mu-receptor opioid antagonists. We reviewed the literature in regard to GI complications using enhanced recovery protocols and share our institutional experience with over 300 patients.

Keywords: Bladder cancer; Complications; Cystectomy; Enhanced recovery; Gastrointestinal.

Publication types

  • Review

MeSH terms

  • Clinical Protocols*
  • Constipation / etiology
  • Constipation / prevention & control
  • Cystectomy / adverse effects*
  • Diarrhea / etiology
  • Diarrhea / prevention & control
  • Humans
  • Ileus / etiology
  • Ileus / prevention & control
  • Nausea / etiology
  • Nausea / prevention & control
  • Postoperative Care*
  • Postoperative Complications
  • Urinary Diversion / adverse effects*
  • Vomiting / etiology
  • Vomiting / prevention & control