NCT05576766

Enhanced Recovery After Surgery (ERAS) Pathway in Patients Undergoing Robot-Assisted Laparoscopic Radical Prostatectomy

Impact of Enhanced Recovery After Surgery (ERAS) Pathway on Outcomes in Patients Undergoing Robot-Assisted Laparoscopic Radical Prostatectomy: A Randomized Controlled Trial

• Status: Not Yet Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 54 (estimated)
• Sponsor: Peking University First Hospital · Academic / Other
• Sex: Male
• Age: 60 Years – 90 Years
• Healthy volunteers: Not accepted

Summary

Prostate cancer ranks second among all malignances in men and has become a significant threat to men's health. Robot-assisted laparoscopic radical prostatectomy (RARP) has become a standard treatment for prostate cancer. How to improve recovery following RARP surgery is worth investigating. The enhanced recovery after surgery (ERAS) pathway involves a series of evidence-based procedures. It is aimed to reduce the systemic stress response to surgery and shorten the length of hospital stay. This randomized trial aims to investigate the impact of Enhanced Recovery After Surgery (ERAS) Pathway on early outcomes after RARP surgery.

Detailed description

Prostate cancer ranks second among all malignancies in men and has become a significant threat to men's health. Surgical resection is the main treatment for patients with early and locally advanced prostate cancer. With the progress of technology, robot-assisted laparoscopic radical prostatectomy (RARP) is gradually accepted by surgeons and become the first line treatment for prostate cancer. How to improve recovery after RARP surgery is worth investigating. The concept of enhanced recovery after surgery (ERAS) was first reported by Dr. Kehlet. The ERAS pathway involves a series of evidence-based managements to accelerate patients' rehabilitation, including selective bowel preparation, nutritional therapy, fluid management, multimodal analgesia, early mobilization, etc. It has been applied to many patient populations including those undergoing gastrointestinal surgery, cardiothoracic surgery, and urological surgery. Previous studies showed that practicing ERAS in patients undergoing laparoscopic prostate surgery shortened the time to flatus and defecate and the length of hospital stay. Specifically, prehabilitation including aerobic exercise and pelvic floor training may be beneficial and improve physical wellbeing in patients undergoing prostatectomy. However, little is known regarding the effects of ERAS in patients undergoing RARP surgery. The purpose of this randomized controlled trial is to investigate the impact of ERAS management, including prehabilitation, on early outcomes in patients undergoing RARP surgery.

Conditions

• Prostate Cancer
• Robot-Assisted Laparoscopic Radical Prostatectomy
• Enhanced Recovery After Surgery (ERAS) Protocol
• Prehabilitation
• Length of Hospital Stay

Interventions

Type	Name	Description
PROCEDURE	Routine care	1. Routine information provided before surgery. 2. No nutritional therapy. 3. No aerobic exercise. 4. No pelvic floor muscle training. 5. No psychiatrist intervention. 6. Bowel preparation with oral cathartic agent. 7. Fasting for over 8 hours; no oral carbohydrate solution (OCS) loading before surgery. 8. Hypothermia prevention not emphasized. 9. General anesthesia; regional block not emphasized. 10. Routine blood pressure management. 11. Mobilization from postoperative day 1. 12. Start oral feeding from postoperative day 1. 13. Patient-controlled analgesia with opioids. 14. Thromboembolism prophylaxis with low-molecular-weight heparin (LMWH). 15. Routine pelvic drainage tube removal (usually at postoperative day 4). 16. Routine urinary catheterization removal (usually at postoperative day 14).
PROCEDURE	ERAS management pathway	1. Patient consultation and education before surgery. 2. Nutritional intervention for patients whose BMI\<18.5 or BMI\>24 kg/m2. 3. Aerobic exercise for 2 weeks before surgery. 4. Pelvic floor muscle training for 2 weeks before surgery. 5. Psychiatrist intervention for patients with severe depression and anxiety. 6. No bowel preparation before surgery. 7. Provide oral carbohydrate solution 2 hours before surgery. 8. Hypothermia prevention. 9. General anesthesia combined with regional block. 10. Goal-directed fluid infusion and targeted blood pressure management. 11. Early mobilization. 12. Early oral feeding. 13. Multimodal analgesia, including opioids and non-steroid anti-inflammatory drugs. 14. Thromboembolism prophylaxis with low-molecular-weight heparin; rivaroxaban for high-risk patients. 15. Early pelvic drainage tube removal (at postoperative day 2) unless contraindicated. 16. Early urinary catheterization removal (at postoperative day 7) unless contraindicated.

Timeline

• Start date: 2025-09-01
• Primary completion: 2026-11-01
• Completion: 2026-12-01
• First posted: 2022-10-13
• Last updated: 2025-08-21

Locations

1 site across 1 country: China