根治性膀胱切除术术前的营养优化
Optimizing Nutrition Prior to Radical Cystectomy.
作者信息
Oberle Anthony D, West Jeremy M, Tobert Conrad M, Conley Gabriel L, Nepple Kenneth G
机构信息
Department of Urology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr., 3RCP, Iowa City, IA, 52243-1089, USA.
出版信息
Curr Urol Rep. 2018 Oct 18;19(12):99. doi: 10.1007/s11934-018-0854-4.
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.
综述目的
营养不良是接受根治性膀胱切除术患者中普遍存在的问题。术前营养不良已被证明会导致术后并发症发生率增加。鉴于根治性膀胱切除术的显著发病率和死亡率，通过营养干预有可能改善患者预后。
最新发现
前瞻性研究表明，在包括根治性膀胱切除术在内的大手术前接受补充免疫营养的患者术后感染率降低。这些对营养优化的初步评估显示出改善预后的巨大潜力。此外，几项采用术后加速康复方案（其中包括术前营养成分）的研究表明，在缩短住院时间方面有益处。新出现的文献表明，术前免疫营养在改善根治性膀胱切除术的术后预后方面具有益处。然而，需要进一步开展工作以确定在根治性膀胱切除术之前优化营养的最佳机制。
Zotero 插件