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 .
No advantage is gained by preoperative bowel preparation in radical cystectomy and ileal conduit: a randomized controlled trial of 86 patients
Objective Bowel preparation ( BP ) is performed routinely before intestinal surgery to reduce the risk of postoperative infectious complications . We studied the effect of BP on patients who underwent radical cystectomy and ileal conduit surgery .  Our goal was to determine whether BP in these patients provided any benefits postoperatively . Methods Between Match 2006 and January 2009 , 86 patients scheduled for radical cystectomy and ileal conduit were r and omized to preoperative BP ( group A ) or surgery without BP ( group B ) . Outcomes studied included operative time , recovery of patient and surgical complications . Results Eighty-six patients were included in the study , 47 in group A and 39 in group B. All surgeries were performed successfully using ileum . Postoperative complications were documented in 5 and 6 patients in groups A and B , respectively . Anastomotic leak occurred in 1 patient in group A , leading to multiple organ dysfunction and sepsis , with a fatal outcome . One case of ileus and three wound infections were also seen in group A. In group B , wound infection and ileus occurred in two patients each , anastomotic leak developed in 1 patient result ing to reoperation and one patient died from pulmonary embolism . No statistical difference in the frequency of complications and recovery of patient was observed between the 2 groups . Conclusions Our results suggest that no advantage is gained by preoperative BP in radical cystectomy and ileal conduit
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 .