Abstract:
OBJECTIVE:To determine the changes in body composition, muscle function and energy expenditure after radical cystectomy (RC). PATIENTS AND METHODS:Eleven consecutive men (median age 66 years, range 44-79) who had a RC over a 1-year period had measurements made of their total body protein, by neutron-activation analysis, total body water by tritium dilution, total body potassium by whole-body counting, resting energy expenditure by indirect calorimetry, and grip strength and respiratory muscle strength. These variables were measured on the day before surgery and at 2 weeks and 6 months after RC. Total body fat was derived using a multicompartment model. Artificial nutritional support was not provided after RC and no oral caloric intake was provided until bowel function returned. RESULTS:Five patients were malnourished before RC and four had significant complications afterward. Over the first 2 weeks there were significant losses in mean (sem) protein levels, at 0.68 (0.17) kg (P < 0.001) and water, at 3.00 (0.73) L (P < 0.001), while body fat was unchanged. Resting energy expenditure was 11% higher than predicted at 14 days after RC (P < 0.001). Body potassium changes mirrored the protein changes but were not statistically significant. Over the subsequent 6 months, 63%, i.e. 0.43 (0.24) kg, of the body protein lost after surgery was regained. Muscle function had returned to baseline levels at 6 months. CONCLUSIONS:This study shows that the catabolic loss of body protein after RC is not regained by 6 months. Regimens directed at early nutritional support after RC for these patients might improve the recovery of body composition, with consequent clinical benefits.
journal_name
BJU Intjournal_title
BJU internationalauthors
Mathur S,Plank LD,Hill AG,Rice MA,Hill GLdoi
10.1111/j.1464-410X.2007.07337.xsubject
Has Abstractpub_date
2008-04-01 00:00:00pages
973-7; discussion 977issue
8eissn
1464-4096issn
1464-410Xpii
BJU7337journal_volume
101pub_type
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pub_type: 临床试验,杂志文章,随机对照试验
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