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[Is total parenteral nutrition necessary in patients subjected to radical cystectomy?]
N Calomino1, G Oliva, M Malerba
1Cattedra di Urologia, Università degli Studi, Siena.
Background:
The aim of the study is to evaluate the nutritional stats in candidates to radical cystectomy in order to minimize post-operative complications.
Methods:
The evaluation is carried out on the basis of anthropometric, bio-humoral and immunologic indexes in a retrospective analysis of patients who underwent major urologic surgery during the last two years. Twenty cases of invasive bladder cancer (mean age 71 years) who underwent radical cystectomy have been studied: in 13 cases urinary diversion by Camey II technique, in 7 cases by Bricker technique has been performed. In 5 cases of orthotopic neo-bladder, endovenous parenteral protein sparing nutrition was carried out for 4 days, in the remaining 15 cases glucidic and saline solutions have been administered.
Results:
In all the 20 evaluated patients post-operative complications have not been observed.
Conclusions:
On the basis of the data obtained, the conclusion is drawn that patients with bladder cancer are generally not so malnourished to need an artificial feeding regimen. Considering the urinary tract substitution effects on renal function and metabolism, particularly for the role of glucose on proximal and distal tubule the usefulness of administering only glucidic solutions and maintaining a good diuresis is underlined.