Objective — to compare the postoperative period according to the standard protocol and in compliance with the enhanced recovery after surgery (ERAS) protocol during radical reconstructive bladder surgery. Material and methods. In 2000 to 2016, the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine performed surgeries as radical cystectomy with orthotopic cystoplasty for Stages II—III bladder cancer. The patients were divided into 2 groups. In Group 1 (n=251), perioperative management of patients was done according to the standard protocol. Group 2 (n=36) underwent perioperative management using the elements of the ERAS protocol. Results. Using the available elements of fast-track surgery (refusal of preoperative fasting, regional anesthesia with prolonged analgesia; intraoperative patient rewarming; early enteral nutrition and revitalization) in Group 2 could decline noticeably the number of postoperative complications, shorten intensive care unit (ICU) stay lengths; reduce the burden of care on medical staff; to speed up patients’ rehabilitation time; and improve the quality of care while maintaining or reducing its costs. Conclusion. The introduction of the ERAS protocol contributed to reductions in the length of ICU stay to 4±1.43 days; in the time of bowel function recovery to 1.33±0.47 days; in the frequency of postoperative complications, and 30-day postoperative mortality rates.