Comparison of Extracorporeal and Intracorporeal Urinary Diversion after Robot-Assisted Radical Cystectomy for Bladder Cancer: A Meta-Analysis.

IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH American Journal of Men's Health Pub Date : 2024-09-01 DOI:10.1177/15579883241274866
Shuhui An, Lei Shi, Yuepeng Liu, Lixin Ren, Kun Zhang, Meng Zhu
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Abstract

To explore the therapeutic efficacy of intracorporeal urinary diversion (ICUD) and extracorporeal urinary diversion (ECUD) after robot-assisted radical cystectomy for bladder cancer through systematic review. This study systematically retrieved electronic databases of PubMed, Web of Science, Cochrane Library, CNKI, and Wanfang to include peer-reviewed studies comparing ICUD and ECUD after robot-assisted radical cystectomy for bladder cancer. Relative risk (RR) and mean difference (MD) were used to represent the pooled effect size and estimate its 95% confidence interval (CI). This study included 15 studies with good quality, involving 5,370 patients undergoing robot-assisted radical cystectomy for bladder cancer. Meta-analysis showed that ICUD reduced intraoperative bleeding volume by 64.12 ml (95% confidence interval [CI]: [-100.95, -27.29]), significantly decreased the risk of blood transfusion (RR: 0.40; 95% CI: [0.24, 0.68]) and gastrointestinal complications (odds ratio [OR]: 0.61; 95% CI: [0.47, 0.80]), with shorter postoperative time of exhaust (MD: -9.27; 95% CI: [-18.47, -0.08]) and oral intake (MD: -0.92; 95% CI: [-1.30, -0.54]). However, ICUD had a relatively longer surgical duration (MD: 30.84 min, 95% CI: [5.03, 56.66]). In addition, there was no statistically significant difference concerning the impact of ICUD and ECUD on the length of stay in the hospital (MD: -0.68d; 95% CI: [-1.79, 0.42]), overall complications (30-day: RR: 1.16; 95% CI: [0.93, 1.46]; and 90-day, RR: 0.85; 95% CI: [0.69, 1.04]) and readmission rate (30-day: RR: 0.96; 95% CI: [0.72, 1.27]; and 90-day: RR: 1.15; 95% CI: [0.80, 1.64]). ICUD after robot-assisted laparoscopic radical cystectomy for bladder cancer exhibits obvious positive effects, especially in reducing the risk of blood transfusion and gastrointestinal complications, and shortening postoperative time of exhaust and oral intake. The findings in this meta-analysis should be confirmed by multiple high-quality studies in the future.

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膀胱癌机器人辅助根治性膀胱切除术后体外引流与体内引流的比较:一项 Meta 分析。
通过系统综述探讨膀胱癌机器人辅助根治性膀胱切除术后体外尿路改道(ICUD)和体外尿路改道(ECUD)的疗效。本研究系统检索了PubMed、Web of Science、Cochrane Library、CNKI和万方等电子数据库,纳入了同行评议研究,比较了机器人辅助膀胱癌根治术后ICUD和ECUD。采用相对风险(RR)和平均差(MD)来表示汇总效应大小,并估算其 95% 置信区间(CI)。该研究纳入了15项质量良好的研究,涉及5370名接受机器人辅助膀胱根治术的膀胱癌患者。Meta 分析显示,ICUD 使术中出血量减少了 64.12 毫升(95% 置信区间 [CI]:[-100.95, -27.29]),显著降低了输血风险(RR:0.40;95% CI:[0.24, 0.68])和胃肠道并发症(几率比[OR]:0.61;95% CI:[0.47,0.80]),术后排气时间(MD:-9.27;95% CI:[-18.47,-0.08])和口服时间(MD:-0.92;95% CI:[-1.30,-0.54])更短。然而,宫内节育器手术时间相对较长(MD:30.84 分钟,95% CI:[5.03, 56.66])。此外,ICUD 和 ECUD 对住院时间(MD:-0.68d;95% CI:[-1.79, 0.42])、总体并发症(30 天:RR:1.16;95% CI:[0.93,1.46];90 天:RR:0.85;95% CI:[0.69,1.04])和再入院率(30 天:RR:0.96;95% CI:[0.72,1.27];90 天:RR:1.15;95% CI:[0.80,1.64])。膀胱癌机器人辅助腹腔镜根治性膀胱切除术后的 ICUD 具有明显的积极作用,尤其是在降低输血和胃肠道并发症风险、缩短术后排气和口服时间方面。这项荟萃分析的研究结果应在未来得到多项高质量研究的证实。
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来源期刊
American Journal of Men's Health
American Journal of Men's Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
3.70
自引率
4.30%
发文量
107
审稿时长
15 weeks
期刊介绍: American Journal of Men"s Health will be a core resource for cutting-edge information regarding men"s health and illness. The Journal will publish papers from all health, behavioral and social disciplines, including but not limited to medicine, nursing, allied health, public health, health psychology/behavioral medicine, and medical sociology and anthropology.
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