Intraoperatively , a fluid and opioid sparing protocol may reduce fluid shifts and avoid complications from paralytic ileus .
Finally , enhanced recovery protocol s including novel medications , early feeding , and multi-modal analgesia approaches are associated with earlier postoperative convalescence .
CONCLUSION RC is a complex and morbid procedure that may benefit from care re design .
OBJECTIVE To present an evidence -based review of the perioperative management of the radical cystectomy ( RC ) patient in the context of a care re design initiative .
Chewing gum has a stimulatory effect on bowel motility in patients after open or robotic radical cystectomy for bladder cancer: a prospective randomized comparative study.
OBJECTIVES To determine whether chewing gum during the postoperative period facilitates the recovery of bowel function and has different efficacy according to operative method used in patients with radical cystectomy . METHODS From July 2007 to September 2009 , we r and omized open radical cystectomy ( ORC ) patients into Group AI ( ORC without gum chewing ) and Group AII ( ORC with gum chewing ) . Robot-assisted radical cystectomy ( RARC ) patients were r and omized into Group BI ( RARC without gum chewing ) and Group BII ( RARC with gum chewing ) . RESULTS A total of 32 ORC ( 17 Group AI and 15 Group AII ) and 28 RARC ( 13 Group BI and 15 Group BII ) patients were completed . The patient 's perioperative data between the control ( AI + BI ) and chewing gum ( AII + BII ) group showed no differences . The median time to flatus and to bowel movement were significantly reduced in chewing gum group compared with the control patients : 57.1 vs. 69.5 hours 76.7 vs. 93.3 hours . In the ORC patients , decrease in time to flatus and bowel movement were observed in gum chewing ( AII ) group than control ( AI ) group : 64.3 vs. 80.3 hours 83.8 vs. 104.2 hours . In RARC patients , decrease in time to flatus and bowel movement were found in gum chewing ( BII ) group than control ( BI ) group : 48.8 vs. 60.3 hours 69.1 vs. 84.6 hours . No adverse effects were observed with chewing gum . CONCLUSIONS Chewing gum had stimulatory effects on bowel motility after cystectomy and urinary diversion . Chewing gum was safe and could be used for postoperative ileus regardless of the operative method ( ORC or RARC )
Intraoperatively , a fluid and opioid sparing protocol may reduce fluid shifts and avoid complications from paralytic ileus .
Finally , enhanced recovery protocol s including novel medications , early feeding , and multi-modal analgesia approaches are associated with earlier postoperative convalescence .
CONCLUSION RC is a complex and morbid procedure that may benefit from care re design .
OBJECTIVE To present an evidence -based review of the perioperative management of the radical cystectomy ( RC ) patient in the context of a care re design initiative .