The adherence of Maghreb urologists to the rehabilitation program improved after radical cystectomy

Abstract

The aim of this study is to evaluate the application of the improved rehabilitation program after total cystectomy. The survey was carried out in 2017 among Maghreb urologists affiliated with their respective learned societies, the Moroccan Society of Urology (AMU), the Tunisian Society of Urology (STU), the Algerian Society of Urological Surgery (SACU) and the Algerian Urology Association (AAU).The self-questionnaire was given to urologists during the congresses of various learned societies on the recommendations of the ERAS program. The number of completed questionnaires is 221 on 383 distributed, of which 115 (52.03%) were answered by Algerian urologists, 85 (38.5%) by Moroccan urologists and 21 (9.5%) by Tunisian urologists.Hospital-university Physicians, hospital and private doctors account for 43%, 21.3% and 35.7% respectively.Urologists report that they have a program to prevent thromboembolic events, hypothermia and peridural analgesia to reduce postoperative pain in 69.6%. A total of 75.6% complies with the recommendations of the postoperative rehabilitation with a rate of 64.7% of the early rise, the prevention of nausea and vomiting in 82.8%, the lack of use of morphine is estimated at 80.1%. The resumption of postoperative feeding is applied in 39.4% of cases. The pre-operative nutritional status, the digestive preparation with a non-residual diet decreases the duration of hospitalization (p = 0.032, p = 0.01, p = 0.009). This survey shows that more than half of the maghrebian urologists report that they are following the recommendations of the improved rehabilitation program to reduce morbidity and decrease the length of hospitalization. The authorisation of the early postoperative feeding remains very little followed.

Keywords

• ERAS
• Fast-track
• Bladder cancer
• Cystectomy