Sanjay G. Patel, MD, outlines the rationale behind implementing Enhanced Recovery After Surgery (ERAS) protocols in order to reduce stress, maintain postoperative physiology, and enhance mobilization for patients undergoing cystectomy. He then reviews the data evaluating different ERAS interventions in each perioperative period.
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Neal D. Shore, MD, discusses the benefits of using blue light cystoscopy (BLC) in adjunct with white light cystoscopy (WLC) in the diagnosis and treatment of bladder cancers. He then reviews the body of evidence evaluating the accuracy of BLC in detecting significant tumors and briefly compares BLC and narrow band imaging.
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Seth P. Lerner, MD, provides the rationale for integrating perioperative chemotherapy and radical cystectomy, describes the evidence supporting neoadjuvant chemotherapy (NAC), and reviews the limited evidence supporting adjuvant therapy for patients with bladder cancer. He then discusses the future of predictive biomarkers and precision medicine in the management of this disease.
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Leonard G. Gomella, MD, FACS, discusses the highly thrombogenic nature of bladder cancer and the burden of thromboembolic complications in patients undergoing radical cystectomy. He then reviews optimal methods and duration of prophylaxis to reduce the risk of these complications.
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Seth P. Lerner, MD, describes the anatomy of and the stage specific association of lymph node metastasis, as well as evidence supporting the anatomic extent of bilateral pelvic lymphadenectomy. Additionally, he provides commentary on current Phase III clinical trials comparing extended lymph node dissection (LND) to standard LND.
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