الفهرس 
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Abstract
Bladder cancer has been the most common cancer in Egypt during the past 50 years. Radical cystectomy with pelvic lymph node dissection remains the standard treatment for patients with muscle invasive bladder cancer. Radical cystectomy is associated with significant morbidity and prolonged postoperative hospital stay than other urological procedures. Cystectomy patients are ideal candidates for enhanced recovery protocol due to small bowel anastomosis, urine within the peritoneal cavity, longer operative time, increased risk of blood loss, and transfusion. Post-operative enhanced recovery protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing the profound stress response following surgery through preoperative counseling, optimization of nutrition, standardized analgesic and anesthetic regimens and early mobilization.
The primary aim of the study was to show the effect of enhanced recovery protocol on postoperative hospital stay for patients undergoing radical cystectomy. The secondary aims were:
Onset of bowel movement.
Onset of early mobilization.
Duration of postoperative intensive care stay .
Postoperative analgesic consumption.
Postoperative complication.
Patient’s satisfaction.
Surgeon satisfaction.<br
After approval from the local and ethical Committee of Menoufia University Hospitals, a prospective observational comparative study was conducted on 50 patients aged from 40 to 70 years old, ASA II and III scheduled for radical cystectomy after obtainingan informed written consent from each of them. They were randomly divided into two groups. 25 patients in first group enrolled in non-ERAS pathway and 25 patients in the second group enrolled prospectively in an ERAS care pathway incorporating multimodal care elements.