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Preoperative immunonutrition prior to radical cystectomy: a pilot study.

Publication ,  Journal Article
Lyon, TD; Turner I I, RM; McBride, D; Wang, L; Gingrich, JR; Hrebinko, RL; Jacobs, BL; Davies, BJ; Tarin, TV
Published in: Can J Urol
August 2017

INTRODUCTION: To investigate the use of a high-arginine immunonutrient supplement prior to radical cystectomy for bladder cancer. MATERIALS AND METHODS: We recruited 40 patients to consume a total of four high-arginine immunonutrient shakes per day for 5 days prior to radical cystectomy. The primary outcome measures were safety, tolerability and adherence to the supplementation regimen. Ninety-day postoperative outcomes were also compared between supplemented patients and a cohort of 104 prospectively identified non-supplemented radical cystectomy patients. Multivariable logistic regression models were used to compare overall complications, infectious complications, and readmission rates between groups. RESULTS: There were no serious adverse events during supplementation. Four patients (10%) stopped supplementation due to nausea (n = 2) and bloating (n = 2). Thirty-three patients (83%) consumed all prescribed shakes. Immunonutrient supplementation was not significantly associated with overall complications (adjusted odds ratio [OR] 1.08; 95% confidence interval [CI] 0.50-2.33), infectious complications (OR 1.23; 95% CI 0.49-3.07), or readmissions (OR 1.48; 95% CI 0.62-3.51) on multivariable analyses. CONCLUSIONS: Preoperative supplementation with a high-arginine immunonutrient shake was safe and well tolerated prior to radical cystectomy. Contrary to prior reports, immunonutrient supplementation was not associated with lower postoperative infectious complications in this cohort, perhaps owing to the 5 day supplementation period. Further study is needed to identify the optimal immunonutrient supplement regimen for radical cystectomy patients.

Duke Scholars

Published In

Can J Urol

ISSN

1195-9479

Publication Date

August 2017

Volume

24

Issue

4

Start / End Page

8895 / 8901

Location

Canada

Related Subject Headings

  • Urinary Bladder Neoplasms
  • Preoperative Care
  • Postoperative Complications
  • Pilot Projects
  • Middle Aged
  • Male
  • Humans
  • Female
  • Cystectomy
  • Arginine
 

Citation

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Lyon, T. D., Turner I I, R. M., McBride, D., Wang, L., Gingrich, J. R., Hrebinko, R. L., … Tarin, T. V. (2017). Preoperative immunonutrition prior to radical cystectomy: a pilot study. Can J Urol, 24(4), 8895–8901.
Lyon, Timothy D., Robert M. Turner I I, Dawn McBride, Li Wang, Jeffrey R. Gingrich, Ronald L. Hrebinko, Bruce L. Jacobs, Benjamin J. Davies, and Tatum V. Tarin. “Preoperative immunonutrition prior to radical cystectomy: a pilot study.Can J Urol 24, no. 4 (August 2017): 8895–8901.
Lyon TD, Turner I I RM, McBride D, Wang L, Gingrich JR, Hrebinko RL, et al. Preoperative immunonutrition prior to radical cystectomy: a pilot study. Can J Urol. 2017 Aug;24(4):8895–901.
Lyon, Timothy D., et al. “Preoperative immunonutrition prior to radical cystectomy: a pilot study.Can J Urol, vol. 24, no. 4, Aug. 2017, pp. 8895–901.
Lyon TD, Turner I I RM, McBride D, Wang L, Gingrich JR, Hrebinko RL, Jacobs BL, Davies BJ, Tarin TV. Preoperative immunonutrition prior to radical cystectomy: a pilot study. Can J Urol. 2017 Aug;24(4):8895–8901.

Published In

Can J Urol

ISSN

1195-9479

Publication Date

August 2017

Volume

24

Issue

4

Start / End Page

8895 / 8901

Location

Canada

Related Subject Headings

  • Urinary Bladder Neoplasms
  • Preoperative Care
  • Postoperative Complications
  • Pilot Projects
  • Middle Aged
  • Male
  • Humans
  • Female
  • Cystectomy
  • Arginine