Immediate total parenteral nutrition after radical cystectomy and urinary diversion

Introduction: The purpose of this study is to determine if administration of total parenteral nutrition (TPN) immediately following radical cystectomy and urinary diversion provides significant recovery benefit when compared to patients who did not receive TPN. Methods: Retrospective chart review was performed on patients who underwent open radical cystectomy and urinary diversion from February 2002 to June 2010. Patients were divided into 2 cohorts-those who received immediate postoperative TPN and those who did not. Preoperative demographics, length of hospital stay, time until tolerating a regular diet and early postoperative complications of the 2 groups were extracted and compared. Results: One hundred seventy-four patients (104 receiving TPN, 70 without TPN) were available for analysis. No significant difference in preoperative characteristics, length of hospital stay, estimated blood loss, or time until tolerating a general diet between the 2 groups was noted. With regard to complications, the incidence of bacteremia was significantly higher in the TPN vs non-TPN cohort (9% vs 1%, P < 0.05). Conclusion: Immediate administration of TPN following radical cystectomy and urinary diversion does not provide a significant postoperative benefit and may lead to an increased risk of bacteremia.