title: Enhanced recovery programmes for patients undergoing radical cystectomy.
abstract: Radical cystectomy is associated with high rates of surgical morbidity. The magnitude of the surgical insult is associated with the degree of stress response, particularly in ageing patients with multiple comorbidities. Attempts to limit this response and identify areas of improvement with respect to patient selection and optimization, anaesthesia, surgical technique and postoperative care underpin the multimodal approach to enhanced recovery pathways. No single intervention significantly reduces morbidity, but the combination of many interventions at all levels of the pathway is likely to accelerate the patient journey from diagnosis to return to normal function.
authors.affiliation: University Hospital Southampton, Tremona Road, Hampshire SO16 6YD, UK.
authors.forename: Julian
authors.initials: J
authors.lastname: Smith
authors.affiliation: Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7235, USA.
authors.forename: Raj S
authors.initials: RS
authors.lastname: Pruthi
authors.affiliation: Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK.
authors.forename: John
authors.initials: J
authors.lastname: McGrath
mesh_terms: D019091:Critical Pathways; D015653:Cystectomy / Q000534:rehabilitation; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D010351:Patient Discharge; D010353:Patient Education as Topic; D018579:Patient Selection; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D020127:Recovery of Function