MP67-14 WHITE BLOOD CELL COUNT AT DISCHARGE FOLLOWING RADICAL CYSTECTOMY ASSOCIATES WITH RISK FOR READMISSION

diversion (UD). Enhanced recovery after surgery (ERAS) protocols focus on avoiding bowel preparation and nasogastric tube, early feeding nonnarcotic pain management and the use of cholinergic and mu-opioid antagonists. We evaluated our ERAS patients for GI postoperative course and complications in the first 30 days after RC and compared them to traditional method of postoperative care. METHODS: Under IRB approval, 241 patients who underwent open RC and UD using our ERAS protocol from 5.2012 to 10.2014 were selected for the study. We used our bladder cancer database to find a matched cohort of RC controls with traditional (non-ERAS) protocol from 2003 to 4.2012. Bowel activity in the postoperative period as well as GI complications of the first 30 days were compared. RESULTS: A total of 145 patients on ERAS arm and 144 matched controls were included in the study. Median time from surgery to first bowel movement was 2 days in ERAS and 5 days in controls (p<0.001). GI complications occurred in 19 (13%) patients on ERAS and 40 (27%) of controls within the first 30 days (p<0.001); the most common was postoperative ileus (POI)/partial small bowel obstruction (pSBO) in both groups (Table 1). Nasogastric tube placement was required in 9 patients (6%) of ERAS compared to 13 (9%) controls (p1⁄40.009). Total parenteral nutrition was required in 1 patient in the ERAS cohort and 8 (6%) controls (p1⁄40.02). Median length of hospital stay (LOS) was significantly shorter in ERAS cohort compared to controls [4 (range, 3 e 16) d vs. 9 (range, 5 e 23) d; p<0.001]. CONCLUSIONS: The ERAS protocol following RC expedites bowel function recovery and shortens LOS with a significant reduction in early GI complications.