Preoperative immunonutrition and carbohydrate loading associated with improved bowel function after radical...

Area of Science:

• Urology
• Surgical Oncology
• Nutritional Science

Background:

• Preoperative malnourishment is linked to adverse outcomes in major abdominal surgeries, including radical cystectomy.
• Enhanced Recovery After Surgery (ERAS) protocols commonly focus on perioperative care, with varying emphasis on nutritional interventions.
• This study uniquely compares ERAS protocols with and without a specific preoperative nutrition component.

Purpose of the Study:

• To evaluate the impact of a formalized preoperative nutrition protocol (PNP) on outcomes following radical cystectomy.
• To compare the effectiveness of an ERAS protocol with a PNP (immunonutrition and carbohydrate drink) against a standard ERAS protocol.

Main Methods:

• A cohort of 78 patients receiving a PNP (immunonutrition and carbohydrate drink) was compared to 92 historical controls.
• Multivariable logistic regression analyses were used to assess the association between preoperative nutrition and key outcomes.
• Outcomes analyzed included 30-day complications, infectious complications, and 30-day readmission rates.

Main Results:

• The preoperative nutrition and control groups were similar in demographic and clinical characteristics.
• Patients receiving the PNP demonstrated an earlier return of bowel function (3.12 vs 3.74 days, P = .0029).
• No significant differences were observed in 30-day complications, infectious complications, or readmission rates between the groups.

Conclusions:

• Implementing a preoperative nutrition protocol with immunonutrition and carbohydrate drinks may facilitate an earlier return of bowel function after radical cystectomy.
• While early bowel function recovery was observed, overall complication and readmission rates were similar in this study.