Sanjay G. Patel, MD, presented “Perioperative Pathways: What We Know Works” during the 3rd Annual International Bladder Cancer Update on January 23, 2019 in Beaver Creek, Colorado.

How to cite: Patel, Sanjay G. “Perioperative Pathways: What We Know Works” January 23, 2019. Accessed Sep 2021. https://grandroundsinurology.com/perioperative-pathways-what-we-know-works/

Perioperative Pathways: What We Know Works

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.

Abstract:

Clinical perioperative pathways in radical cystectomy have evolved over the last several decades. The concept of “fast-track” surgery emerged in the 1990s with the purpose of standardizing perioperative care. Since then, numerous surgical specialties have implemented Enhanced Recovery After Surgery (ERAS) pathways, a specific subset of perioperative clinical care protocols, with reported success.

This standardization of pathways reduces variability of care. It will also allow physicians to incorporate evidence based practices to improve efficiency and reduce morbidity of perioperative care. In order for this program to be successful, a team effort from multiple care providers and the patient is vital.

Given their demonstrable efficacy, this presentation will evaluate the detailed practices and data that encompass ERAS pathways as they pertain to radical cystectomy. In the preoperative period the conversation will cover the data and ERAS Society recommendations for pre-cystectomy counseling, bowel prep, fasting, carbohydrate loading, thromboembolic prophylaxis. The operative topics included will be anesthetic protocol, regional anesthesia, and individual goal-directed fluid therapy. Finally, the postoperative protocols discussed will be nasogastric tube removal, gum chewing, alvimopan administration, and early enteral feeding.

About the International Bladder Cancer Update

The International Bladder Cancer Update (IBCU) is an annual one-day CME conference focused on bladder cancer treatment updates. IBCU takes place during its sister conference, the International Prostate Cancer Update (IPCU). The conference’s faculty consists of international experts, and the event caters to urologists, urologic oncologists, and other healthcare professionals. In addition to didactic lectures, IBCU features interactive discussions, a panel roundtable, debates, and case presentations. Dr. Patel presented this lecture during the 3rd IBCU in 2019. Please visit this page in order to learn more about future IBCU meetings.