Optimizing Nutrition Prior to Radical Cystectomy

Abstract

Purpose of review: Malnutrition in a prevalent problem in patients undergoing radical cystectomy. Preoperative malnutrition has been shown to contribute to increased rates of postoperative complications. Given the significant morbidity and mortality of the procedure of radical cystectomy, there is potential for improvement in patient outcomes by nutritional intervention.

Recent findings: Prospective studies have demonstrated a reduction in postoperative infection rates in patients who receive supplemental immunonutrition prior to major surgery including radical cystectomy. These initial evaluations of nutritional optimization show significant potential for improved outcomes. Additionally, several studies using enhanced recovery after surgery protocols, which include a preoperative nutritional component, have shown a benefit in reducing length of stay. Emerging literature has shown the benefits of preoperative immunonutrition in improving postoperative outcomes of radical cystectomy. However, further work is needed to determine the best mechanism to optimize nutrition prior to radical cystectomy.

Keywords: Bladder cancer; Cystectomy; Malnutrition; Nutrition.

Conflict of interest statement

Conflict of Interest Anthony D. Oberle, Jeremy M. West, Conrad M. Tobert, Gabriel L. Conley, and Kenneth G. Nepple each declare no potential conflicts of interest.