Preoperative immunonutrition prior to radical cystectomy: a pilot study

Area of Science:

• Oncology
• Surgical Nutrition
• Immunonutrition

Background:

• Bladder cancer management often involves radical cystectomy.
• Optimizing patient nutritional status preoperatively may improve surgical outcomes.
• High-arginine immunonutrient supplements are explored for their potential benefits in surgical patients.

Purpose of the Study:

• To assess the safety, tolerability, and adherence of a high-arginine immunonutrient supplement regimen in patients undergoing radical cystectomy.
• To compare 90-day postoperative outcomes between patients receiving the supplement and a control group.

Main Methods:

• A cohort of 40 patients received high-arginine immunonutrient shakes for 5 days pre-surgery.
• Safety, tolerability, and adherence were primary outcomes.
• Postoperative complications (overall, infectious) and readmissions were compared to 104 non-supplemented patients using multivariable logistic regression.

Main Results:

• The supplement was safe and well-tolerated, with 83% adherence.
• No serious adverse events were reported.
• Supplementation showed no significant association with reduced overall complications, infectious complications, or readmissions.

Conclusions:

• Preoperative high-arginine immunonutrient supplementation is safe and well-tolerated in radical cystectomy patients.
• A short, 5-day supplementation period did not lead to reduced postoperative infectious complications in this study.
• Further research is required to determine optimal immunonutrient supplementation protocols for radical cystectomy patients.