Editing Muscle-Invasive Bladder Cancer (section)

==== Perioperative surgical management====
*'''Clinicians should attempt to optimize patient performance status in the perioperative setting.'''
**'''Optimizing nutritional status prior to surgery; preoperative carbohydrate loading in order to diminish postoperative insulin resistance'''
**'''Smoking cessation counseling'''
**'''Consider not routinely prescribing a mechanical bowel preparation when only small bowel will be used for urinary tract reconstruction'''
*'''<span style="color:#ff0000">Perioperative pharmacologic thromboembolic prophylaxis should be given to patients undergoing radical cystectomy.[https://pubmed.ncbi.nlm.nih.gov/28456635/ ★]</span>'''
**'''<span style="color:#ff0000">Combined mechanical and pharmacologic prophylaxis is recommended.</span>'''
***Strong consideration should be given to initiating pharmacologic prophylaxis just prior to induction of anesthesia; however, the risks of bleeding need be weighed against the benefits of prophylaxis in determining the timing of heparin administration.
**'''Perioperative coverage with up to 4 weeks of treatment following surgery may be beneficial.'''
*'''μ-opioid antagonist therapy should be used to accelerate gastrointestinal recovery, unless contraindicated.'''
**'''μ-opioid antagonist therapies are contraindicated in patients who have taken opioids for ≥ 1 week prior to surgery'''
*Patients should receive detailed teaching regarding care of urinary diversion prior to discharge from the hospital