Impact of Implementing a Multidisciplinary Enhanced Recovery Program on Hospital Stay for Patients Undergoing Radical Prostatectomy: A Retrospective Cohort Study

Background Enhanced recovery after surgery (ERAS) protocols are evidence-based, multidisciplinary approaches designed to minimize perioperative stress, accelerate patient recovery, and reduce healthcare resource utilization. Although well-established in colorectal and other major abdominal surgeries, evidence supporting their effectiveness in laparoscopic radical prostatectomy (LRP) remains limited. This retrospective cohort study evaluated whether implementing an enhanced recovery program (ERP), specifically adapted for LRP, would reduce hospital length of stay (LOS) and maintain patient safety. Methods A total of 60 patients undergoing radical prostatectomy were retrospectively analyzed and divided into three cohorts: a historical control group (pre-ERP, n=20), an implementation group (ERP compliance <70%, n=20), and a consolidated group (ERP compliance >70%, n=20). Primary outcome measures included hospital LOS, while secondary outcomes encompassed postoperative complications graded by Clavien-Dindo classification, protocol compliance rates, readmissions, and reoperations. Results Median hospital LOS significantly decreased following ERP implementation, from five days in the historical group to three days (p<0.001) in the implementation cohort, and further declined to two days (p<0.001) in the consolidated cohort. Higher ERP compliance (>70%) was strongly associated with shorter hospitalization. Importantly, ERP implementation did not increase the incidence of severe postoperative complications (Clavien-Dindo grades III-V), readmissions, or reoperations. Conclusions Implementing a structured ERP for laparoscopic radical prostatectomy significantly reduced hospital LOS without negatively impacting patient safety. Higher compliance with ERP elements was strongly correlated with enhanced patient outcomes. These findings highlight the clinical benefits of ERP adoption and underscore the importance of multidisciplinary adherence for optimizing surgical recovery and healthcare efficiency.