Introduction:

Radical cystectomy (RC) is the gold standard treatment for patients with muscle-invasive or refractory non-muscle invasive bladder cancer. It is estimated that approximately 64% and 13% of RC patients experience any complication and major complications, respectively. Specialized immunonutrition (SIM) aims to reduce the rates of complications after RC. We reported surgical complication rates in RC patients who received (SIM group) versus who did not receive (no-SIM group) perioperative SIM. Moreover, we investigated factors associated with complications after RC.

Material and Methods:

This is a retrospective cohort study of 52 patients who underwent RC between April 2016 and December 2017. Overall, 26 (50%) patients received perioperative SIM. We recorded age, gender, Charlson Comorbidity Index (CCI), body mass index (BMI), Malnutrition Universal Screening Tool (MUST) score, unintentional weight loss (UWL), SIM drinks consume, surgical approach, urinary diversion, neoadjuvant chemotherapy (NAC), use of total parenteral nutrition (TPN), final pathology, length of stay (LOS), and complications.

Results:

SIM was associated with higher rates of documented infections (P = .03). Conversely, post-operative ileus was associated with higher rates of overall infections (P = .03). Median LOS was comparable within the 2 groups. Overall, 4 (15.38%) versus 0 (0%) patients in SIM versus no-SIM group were readmitted to hospital (P = .03). Age, CCI, NAC, and TPN were not associated with complication rates.

Conclusions:

SIM is not associated with lower rates of post-operative complications in RC candidates. Moreover, higher rates of documented infections were observed in the SIM group. Patients with post-operative ileus experienced more infections. Age, CCI, NAC, and TPN were not predictive of complications.

中文翻译：

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围手术期免疫营养对接受根治性膀胱切除术患者并发症的影响：回顾性分析

介绍：

根治性膀胱切除术 (RC) 是肌肉浸润性或难治性非肌肉浸润性膀胱癌患者的金标准治疗方法。据估计，大约 64% 和 13% 的 RC 患者分别出现任何并发症和主要并发症。专门的免疫营养 (SIM) 旨在降低 RC 后并发症的发生率。我们报告了接受（SIM 组）与未接受（无 SIM 组）围手术期 SIM 的 RC 患者的手术并发症发生率。此外，我们调查了与 RC 后并发症相关的因素。

材料与方法：

这是一项对 2016 年 4 月至 2017 年 12 月期间接受 RC 的 52 名患者进行的回顾性队列研究。总体而言，26 名 (50%) 患者接受了围手术期 SIM。我们记录了年龄、性别、查尔森合并症指数 (CCI)、体重指数 (BMI)、营养不良通用筛查工具 (MUST) 评分、无意体重减轻 (UWL)、SIM 饮料消耗、手术方法、尿流改道、新辅助化疗 (NAC) )、全胃肠外营养 (TPN) 的使用、最终病理、住院时间 (LOS) 和并发症。

结果：

SIM 与更高的记录感染率相关 ( P  = .03)。相反，术后肠梗阻与较高的总体感染率相关 ( P  = .03)。两组的中位 LOS 具有可比性。总体而言，SIM 组和非 SIM 组中 4 (15.38%) 和 0 (0%) 名患者再次入院 ( P  = .03)。年龄、CCI、NAC 和 TPN 与并发症发生率无关。

结论：

SIM 与 RC 候选者的术后并发症发生率较低无关。此外，在 SIM 组中观察到更高的记录感染率。术后肠梗阻患者感染更多。年龄、CCI、NAC 和 TPN 不能预测并发症。