Bowel Preparation and Peri-operative Management for Radical Cystectomy in Turkey: Turkish Urooncology Association Multicenter Survey

PURPOSE: To investigate the preferences and practice patterns of urooncologicsurgeons in Turkey on bowel preparation and peri-operative management forradical cystectomy.MATERIALS AND METHODS: This study was conducted by Turkish Uro oncology Association as a multicenter survey. Participants were asked to fill in questionnairesdispensed at annual oncologic meeting or using internet access to the website of Urooncology Association. The questionnaire consisted of multiplechoice or open-ended questions related to frequency of cystectomy, surgicaltechnique and type of diversion, bowel preparation protocol, nasogastric tubeapplications, antibiotic prophylaxis, and deep vein thrombosis prophylaxis.Collected data from the survey were presented descriptively.RESULTS: Forty-four questionnaires from 44 surgeons of different centerswere evaluated. All participants answered that they always perform bowelpreparation before cystectomy. Four participants reported that they had anexperience of cystectomy without bowel preparation. Bowel preparationmethods included long conservative methods, short enema protocols, and Golytely, but there were significant differences in application of each method.Of participants, 88.6% perform diversion by themselves whereas others askhelp from a general surgeon. Antibiotic prophylaxis is preferred mostly by 2agents using third-generation cephalosporins and metronidazole for a periodof 5 days or more in the majority. Type, duration, and dosage of deep veinthrombosis prophylaxis differed among participants.CONCLUSION: There are significant individual differences in peri-operativemanagement of radical cystectomy, which render deficient and sometimesinadequate patient care. There is a need to establish standard protocols forbowel preparation and adequate peri-operative management for radicalcystectomy.