Evaluation of the effectiveness of the enhanced recovery protocol in laparoscopic plastic surgery on the ureter and the ureteropelvic junction

The Enhanced Recovery Program (ERP) is a special strategy of perioperative management aimed at reducing the duration of treatment with improved postoperative outcomes. There are several main causes of persistent violation of the evacuation function of the kidneys. These are mainly strictures of the ureter or the ureteropelvic junction.

The aim of the study was a comparative analysis of the outcomes of the use of the developed protocol of enhanced recovery in laparoscopic plastic surgery on the ureter and the ureteropelvic junction.

Material and methods. A prospective randomized blind study was performed on 90 patients who were treated in the period 2017-2022. All patients were divided into two comparison groups: the standard treatment protocol (n=46, group I; St), and the group cured by the ERP protocol (n=44, group II; ER).

Results. Both protocols lead to recovery (91.3% vs 95.4%; p=0.883), with a similar level of postoperative complications of classes I–III (p>0.05), indicators of postoperative status (p>0.05) and comparable efficacy after two years of postoperative follow-up (p=0.430), without increasing the risks of repeated treatment or reoperations (p>0.05).

The use of the ERP protocol makes it possible to shorten the period of treatment; reduce postoperative pain (according to VAS); achieve a better postoperative functional state (according to the severity of nausea, vomiting, USSQ and other parameters); shorten the duration of stenting and catheterization (p <0.05).

Conclusion. The use of the developed protocol of enhanced recovery makes it possible to improve the results of surgical treatment of strictures of the ureteropelvic junction and ureter.

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