MP41-18 THE INFLUENCE OF ENHANCED RECOVERY PROGRAMME ON PATIENT REPORTED CONVALESCENCE AND HEALTH-RELATED QUALITY OF LIFE AFTER ROBOTIC ASSISTED RADICAL CYSTECTOMY

Field: Medicine (Health Sciences)

You have accessJournal of UrologyBladder Cancer: Invasive III1 Apr 2018MP41-18 THE INFLUENCE OF ENHANCED RECOVERY PROGRAMME ON PATIENT REPORTED CONVALESCENCE AND HEALTH-RELATED QUALITY OF LIFE AFTER ROBOTIC ASSISTED RADICAL CYSTECTOMY Dimitrios Moschonas, Pavlos Pavlakis, Murthy Kusuma, Stylianos Chintzoglou, Chris Jones, Alison Roodhouse, Simon Woodhams, Michael Swinn, Hugh Mostafid, Matthew Perry, Krishnaji Patil, and Dimitrios Moschonas Dimitrios MoschonasDimitrios Moschonas More articles by this author , Pavlos PavlakisPavlos Pavlakis More articles by this author , Murthy KusumaMurthy Kusuma More articles by this author , Stylianos ChintzoglouStylianos Chintzoglou More articles by this author , Chris JonesChris Jones More articles by this author , Alison RoodhouseAlison Roodhouse More articles by this author , Simon WoodhamsSimon Woodhams More articles by this author , Michael SwinnMichael Swinn More articles by this author , Hugh MostafidHugh Mostafid More articles by this author , Matthew PerryMatthew Perry More articles by this author , Krishnaji PatilKrishnaji Patil More articles by this author , and Dimitrios MoschonasDimitrios Moschonas More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1305AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Quality of life is an important consideration after complex cancer surgery. Data on quality of life after radical cystectomy are still scarce. Our aim was to analyse the impact of robotic assisted radical cystectomy (RARC) and urinary diversion with multimodal enhanced recovery protocol on peri-operative outcomes and postoperative health-related quality of life (HRQOL) at multiple prospective time points. METHODS A total of 240 consecutive patients underwent RARC after the establishment of a new tertiary cystectomy service in April 2013. HRQOL was prospectively assessed preoperatively, after 6 and 12 months, using the QLQ-C30 questionnaire. Analysis of outcomes to demographic and perioperative variables was performed. RESULTS The median age at treatment was 71 years old, 76% were males, 72% had a BMI <30kg/m2, 81% an ASA score ≤ 2 and 72% a CPET anaerobic threshold ≥ 11. The median LOS was 5 days (1st-3rd IQR: 4-7 days). Post-operative day 4 was the most frequent day of discharge from hospital. The incidence of post-operative complications was 42% for minor (Clavien-Dindo grade ≤ II) and 8% for major (grade ≥ III) complications. Major complications led to reduced physical functioning (PF) levels after 6 months (p = 0.050) without effect on global health status (GHS) (p = 0.825). HRQOL seems to improve to similar or better levels compared to baseline after 1 year. Subgroup analysis revealed greater improvement in PF in intra vs extra corporeal diversion (p = 0.049) but no differences between neobladder and ileal conduit. CONCLUSIONS Perioperative complications and complicated recovery after RARC can affect HRQOL subdomains but do not significantly influence the GHS. Post operative QOL invariably improves in 1 year after surgery while patient reported outcomes are comparable after either continent or incontinent urinary diversion. Totally intracorporeal minimal invasive approach followed by multimodal enhanced recovery programme is ensuring better short and long term overall HRQOL outcomes. Selection of diversion should be tailored to patient′s preference after comprehensive counselling with multidisciplinary team since there is no demonstrable benefit of continent reconstruction. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e535 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Dimitrios Moschonas More articles by this author Pavlos Pavlakis More articles by this author Murthy Kusuma More articles by this author Stylianos Chintzoglou More articles by this author Chris Jones More articles by this author Alison Roodhouse More articles by this author Simon Woodhams More articles by this author Michael Swinn More articles by this author Hugh Mostafid More articles by this author Matthew Perry More articles by this author Krishnaji Patil More articles by this author Dimitrios Moschonas More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...