title: Introduction of an Enhanced Recovery after Surgery Protocol for Robot-Assisted Laparoscopic Radical Prostatectomy.
abstract: BACKGROUND
  No studies have shown whether the enhanced recovery after surgery (ERAS) protocol is superior to the conventional protocol after robot-assisted laparoscopic radical prostatectomy (RALP). We compared intestinal function and perioperative parameters of patients with prostate cancer after the ERAS and conventional protocols to determine the superior protocol for recovery of intestinal function.
  
  
  METHODS
  A retrospective analysis of 198 consecutive patients who underwent RALP between August 2013 and June 2015 was conducted. Our study design included 2 cohorts. Patients underwent conventional care in one group (n = 123) and the ERAS protocol in the other group (n = 75). The primary outcome was the time to first defecation. Secondary outcomes were perioperative parameters and the complication rate.
  
  
  RESULTS
  The ERAS group showed a significantly shorter time to first defecation than did the conventional group (p = 0.006). Multivariate analysis showed that selection of the ERAS protocol was significantly associated with the number of days for first time to defecation.
  
  
  CONCLUSIONS
  Successful application of an ERAS protocol was applied to our patients who underwent RALP and did not have major complications. The ERAS protocol included enhanced intestinal recovery. The ERAS group showed a significantly shorter time to first defecation than did the conventional group.
authors.affiliation: Department of Urology and Andrology, Graduate School of Medicine, Kansai Medical University, Osaka, Japan.
authors.forename: Motohiko
authors.initials: M
authors.lastname: Sugi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsuda
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Hisanori
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Takao
authors.initials: T
authors.lastname: Mishima
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yanishi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Komai
authors.forename: Kaneki
authors.initials: K
authors.lastname: Yasuda
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Kenji
authors.initials: K
authors.lastname: Yoshida
authors.forename: Masato
authors.initials: M
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D003672:Defecation; D006801:Humans; D007422:Intestines / Q000502:physiology; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015397:Program Evaluation; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
keywords: Enhanced recovery after surgery; Fast-track; Robot-assisted laparoscopic radical prostatectomy