Management of the Gastrointestinal Tract at the Time of Cystectomy

Abstract

Radical cystectomy impacts on the gastro-intestinal tract in several ways. Clearly there is the need for bowel mobilisation, resection and anastamosis in order to create a urinary diversion, and the use of bowel preparation or antibiotics are controversial topics. Post-operatively ileus is common and there is debate about the routine use of NG tubes. Early enteral feeding is a modern concept but not yet proven. In the long-term there can be problems such as diarrhoea and B12 deficiency. All of these issues are discussed in this review using the latest available evidence.

The Role of Mechanical Bowel Preparation before Ileal Urinary Diversion: A Systematic Review and Meta-Analysis

“…The formation of this concept has much to do with the following reasons: (1) Bacteria, which were often considered the culprit of relative complications, can be reduced to a maximum [26]. (2) Without the impact by intraluminal hard feces, the anastomotic stoma is relative safer [27].…”