Perceptions versus reality, do we do what we think we do?

Perceptions versus reality, do we do what we think we do?

Baack Kukreja JE, Messing EM, Shah JB. Are we doing “better”? The discrepancy between perception and practice of enhanced recovery after cystectomy principles among urologic oncologists. Urol Oncol. 2016 Mar;34(3):120.e17-21.

What is already known?

ERAS society has published guidelines for patients undergoing radical cystectomy. (Link) But the uptake of ERAS programs in the US is unclear, so this study attempted to survey US cystectomy surgeons to establish current perioperative care. 

What this paper adds?

The authors had a 50% overall response rate from the survey, with 64% stating that they were following ERAS principles. However this study found that only 20% of respondents actually practiced all elements.

High adherence to the ERAS protocol may be associated with improved 5-year cancer-specific survival after colorectal cancer surgery (Gustafsson 2016). Whilst we do not know that this can be applied to cystectomy surgery, more work needs to be done to improve this low compliance rate.

Chris Jones, Guildford.