Effect of Perioperative Immunonutrition on Early-Postoperative Complications in Patients Undergoing Radical Cystectomy for Bladder Cancer: A Case Series

<b>Objective:</b> The objective was to evaluate the impact of perioperative immunonutrition (IN) on postoperative complications in patients undergoing radical cystectomy (RC) for bladder cancer (BC). <b>Methods:</b> A prospective case series of 19 patients treated with perioperative IN between October 2022 and July 2023 was conducted. Patients received preoperative IN based on nutritional risk and postoperative IN with gradual recovery of normal feeding. The inclusion criteria encompassed clinically node-negative patients without metastatic disease. The outcomes were assessed using Clavien-Dindo classification and included infectious complications, wound healing disorders, ileus, anemia, genitourinary issues, recovery time, and compliance with the nutritional regimen. <b>Results:</b> Sixteen patients (84.2%) experienced complications. Most were low-grade (CD 1-2), with no CD > 3a. Wound disorders affected 10.5% and anemia requiring transfusion occurred in 47.4% of patients, infectious complications were reported in 26.3%, and ileus in 36.8%. The median time to first flatus was 2 days (IQR 2-3), while resumption of oral feeding occurred after 4 days (IQR 2-5), like mobilization (IQR 2-5). The median hospital stay was 14 days (IQR 11-18). Compliance with IN was 78.9%, with gastrointestinal intolerance being the primary cause of discontinuation. <b>Conclusions:</b> Patients with RC undergoing perioperative IN showed low rates of high-grade complications and promising results in bowel function recovery and infection rates. Further randomized controlled trials are required to validate these results.