Table of Contents
ISRN Urology
Volume 2012 (2012), Article ID 382843, 6 pages
http://dx.doi.org/10.5402/2012/382843
Research Article

Current Strategies to Enhance Recovery following Radical Cystectomy: Single Centre Initial Experience

1Department of Urology, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK
2Department of Anaesthetists, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK

Received 27 November 2011; Accepted 22 December 2011

Academic Editors: C. A. Podlasek and A. K. Singla

Copyright © 2012 Nikhil Vasdev et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A radical cystectomy (RC) with pelvic lymph node dissection is the gold standard treatment for muscle-invasive bladder carcinoma. The morbidity associated with RC is clearly lower than that in the previous decades; it still continues to remain higher than 30% in the early postoperative period associated with and remains the most effective method for local control. We present current strategies being developed to further enhance recovery in patients undergoing RC and stratifying these into pre, intra, and post operative. We present our current strategies to enhance revcovery in patients undergoing RC which includes a combination of a through preoperative assessment with cardiopulmonary exercise (CPX), preoperative carbohydrate loading drinks, and intraoperative fluid monitoring with the trans-oesophageal Doppler probe (TODP) that may enhance recovery following radical cystectomy. We conclude that using these strategies may not only help in reducing peri/post operative morbidity and the duration of inpatient stay but may also help in enhancing the patient’s long-term recovery.