Comment on: Postoperative outcomes of Fast-Track-enhanced recovery protocol in open radical cystectomy: comparison with standard management in a high-volume center and Trifecta proposal

Radical cystectomy (RC) with pelvic lymphnode dissection and intestinal urinary diversion is the standard treatment for muscle invasive bladder cancer (BC) and very high-risk non-muscle invasive BC, and represents a significant surgical challenge to both patients and urologists. Despite improvements in surgical technique and perioperative medical care, RC is still associated with a high rate of postoperative complications and mortality. The ERAS protocol was first introduced in the 1990s applied to colorectal surgery, as a multimodal perioperative care pathway to enhance recovery after surgery. The ERAS protocol applied to RC has shown to result in shorter length of stay (LOS), fewer major complications and reduced costs. However, this has been demonstrated mainly in single-institution series with varying heterogeneity across different protocols.In this issue of MUN, authors prospectively evaluated post-operative outcomes of ERAS compared to standard protocol according to surgeon’s preference in 191 patients treated with RC.