{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:16:21Z","timestamp":1789474581304,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T00:00:00Z","timestamp":1525910400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T00:00:00Z","timestamp":1525910400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Although enhanced recovery after surgery (ERAS) components include both anesthesia and surgical care processes, it is unclear whether a multidisciplinary approach to implementing ERAS care processes improves clinical outcomes. The addition of multidisciplinary care with anesthesiology\u2010related components to an existing ERAS protocol for radical cystectomy at a US comprehensive cancer center provided an opportunity to compare short\u2010 and long\u2010term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively compared the outcomes of 116 consecutive patients who underwent cystectomy after implementation of a multidisciplinary ERAS protocol with those of a historical control group of 143 consecutive patients who had been treated with a surgical ERAS protocol. Length of stay, return of bowel function, rate of blood transfusion, nausea, pain, and readmission rates were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Implementation of a multidisciplinary ERAS protocol was associated with better postsurgical symptom control, as indicated by lower rates of patient\u2010reported nausea (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05). Multivariate Poisson regression analysis showed a decrease in estimated intraoperative transfusions (<jats:italic>P<\/jats:italic>\u2009\u2264\u2009.001) after adjusting for the effects of potential confounding variables. There were no statistically significant differences noted in length of stay, return of bowel function, 30\u2010 and 90\u2010day complications, or readmissions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first study to investigate the effects of adding anesthesia ERAS components to an existing surgical ERAS protocol for radical cystectomy. We found that with the addition of anesthesia\u2010related interventions, there was a decrease in transfusions and nausea.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-018-4665-z","type":"journal-article","created":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T19:00:08Z","timestamp":1525978808000},"page":"2701-2707","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Improved Outcomes of Enhanced Recovery After Surgery (ERAS) Protocol for Radical Cystectomy with Addition of a Multidisciplinary Care Process in a US Comprehensive Cancer Care Center"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8279-7778","authenticated-orcid":false,"given":"Sephalie Y.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Anesthesiology H. Lee Moffitt Cancer Center and Research Institute 12902 Magnolia Drive 33612 Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemarie E.","family":"Garcia Getting","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology H. Lee Moffitt Cancer Center and Research Institute 12902 Magnolia Drive 33612 Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Alford","sequence":"additional","affiliation":[{"name":"University of South Florida, Morsani College of Medicine Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Hussein","sequence":"additional","affiliation":[{"name":"University of South Florida, Morsani College of Medicine Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Braydon J.","family":"Schaible","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics H. Lee Moffitt Cancer Center and Research Institute Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Boulware","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics H. Lee Moffitt Cancer Center and Research Institute Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae K.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics H. Lee Moffitt Cancer Center and Research Institute Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott M.","family":"Gilbert","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Oncology H. Lee Moffitt Cancer Center and Research Institute Tampa FL USA"},{"name":"Department of Health Outcomes and Behavior H. Lee Moffitt Cancer Center and Research Institute Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio M.","family":"Powsang","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Oncology H. Lee Moffitt Cancer Center and Research Institute Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wade J.","family":"Sexton","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Oncology H. Lee Moffitt Cancer Center and Research Institute Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe E.","family":"Spiess","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Oncology H. Lee Moffitt Cancer Center and Research Institute Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Poch","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Oncology H. 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