[Usefulness++ of total parenteral nutrition in radical surgery for bladder cancer].
Thirty patients diagnosed with non-metastatic infiltrating vesical cancer (pT2-3, NoMo) due to receive radical cystectomy and transintestinal urinary by-pass, underwent Pre-operative Nutritional Assessment (PRNA), Cystectomy, post-operative Total Parenteral Nutrition (TPN), and Post-operative Nutritional Assessment (PONA) in day 7. The purposes of this prospective, uncontrolled clinical trial were: to identify, prior to surgery, undernourished patients, to assess the effectiveness of post-operative TPN with regard to a decrease in morbidity and mortality, and to evaluate the influence of a deficient nutritional condition in the occurrence of post-operative complications. It was found the 16.6% patients were undernourished prior to surgery, 80% of which showed complications, while only 28% patients considered to be in a normal state of nutrition had complications (there were no fistulae, intraabdominal abscesses, and abdominal sepsis). 6.6% complications were TPN-related. The conclusions were: the percentage of patients with malnutrition prior to surgery is large enough to justify a routine PRNA; TPN decreases morbidity and mortality in patients with previous good nutritional state but not in those with malnutrition; undernourished patients have a very high rate of complications and surgery should be delayed until a acceptable state of nutrition is achieved.
Herranz Amo
F
F
Servicio de Urología, Hospital General Gregorio Marañón, Madrid.
García Peris
P
P
Jara Rascón
J
J
Moncada Iribarren
I
I
Basquero González
B
B
Martín Martínez
J C
JC
Díez Cordero
J M
JM
Verdú Tartajo
F
F
D015653:Cystectomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000150:complications / Q000628:therapy; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000601:surgery / Q000628:therapy*; D014547:Urinary Diversion / Q000009:adverse effects
Utilidad de la nutrición parenteral total en la cirugía radical del cáncer vesical.