ADAPTATION OF THE ERAS PROTOCOL FOR PATIENTS WITH UROSTOMY AFTER BRICKER ILEAL CONDUIT: THE ROLE OF STRUCTURED PERIOPERATIVE STOMA CARE

Current Enhanced Recovery After Surgery (ERAS) protocols—initially developed for colorectal and abdominal surgery and subsequently extrapolated to radical cystectomy—predominantly focus on general surgical elements (pain management, nutritional support, early mobilization) while overlooking the specifics of intestinal urostomy formation. Meanwhile, patient adaptation to life with a stoma is a critical determinant of quality of life, psychological well-being, and the incidence of peristomal complications (skin maceration, parastomal hernia, stomal stenosis, retraction), which occur in 20–45% of patients across various postoperative intervals. The lack of a standardized, structured component of preoperative education and perioperative stoma care guidance within standard ERAS pathways can compromise overall protocol efficacy in patients undergoing the Bricker procedure, serving as an independent driver of unplanned medical visits and hospital readmissions after discharge.