■由于可用的不同方法,膀胱癌治疗中的尿路改道一直是人们感兴趣的杰出主题。在他们当中,回肠导管(IC)和经输尿管造口术(TUU)已成为临床实践中的热门选择。这项研究希望比较接受RC手术的患者中IC和TUU的长期结果。
■文献检索在MEDLINE进行,中部,和EMBASE。住院时间,并发症发生率,生活质量,选择生存率作为结局.使用ROBINS-I工具评估偏倚风险。使用Macintosh的ReviewManagerV.5中的森林图汇总了结果度量。使用DerSimonian和Laird随机效应模型测量异质性。
■纳入了18项匹配的介入研究,3是前瞻性研究。纳入样本总数为3,689;TUU组1,172名患者和IC组2,517名患者。IC手术与住院时间延长相关[平均差3.80[95%置信区间(CI):2.27-5.32),p<0.001,I2=92%]。重症监护的持续时间没有显着差异。主要并发症发生率[比值比(OR)=1.45,95%CI:0.74-2.84,p=0.27,I2=54%]:结石形成(OR=1.07,95%CI:0.51-2.23,p=0.48,I2=0%),TUU组和IC组之间的肾功能恶化(OR=0.81,95%CI:0.39-1.68,p=0.57,I2=0%)。两组的生活质量下降,并且仅发生在造口放置阶段后的早期。各组之间的生存率没有差异。
■TUU是一种更好的UD选择,因为它可以缩短住院时间,有类似的主要并发症,生活质量,与IC相比的生存率。
UNASSIGNED: Urinary diversion in bladder cancer treatment has been a distinguished topic of interest due to varying approaches available. Amongst them, ileal conduit (IC) and transuretero-ureterostomy (TUU) have been popular options in clinical practice. This study would like to compare the long-term outcomes of IC and TUU in patients undergoing RC procedures.
UNASSIGNED: Literature searches were conducted in MEDLINE, CENTRAL, and EMBASE. Duration of hospitalization, complication rate, quality of life, and survival rate were selected as outcomes. Risk of bias was assessed using the ROBINS-I tool. Outcome measure was pooled using forest plot in Review Manager V.5 for Macintosh. Heterogeneity was measured using the DerSimonian and Laird random-effects model.
UNASSIGNED: Eighteen matching interventional studies were included, 3 were prospective studies. The total number of included samples was 3,689; 1,172 patients of the TUU and 2,517 of IC group. The IC procedure associates with longer hospitalization [mean difference 3.80 [95% confidence interval (CI): 2.27-5.32), p < 0.001, I2 = 92%]. Duration of intensive care did not differ significantly. There were no differences in major complication rates [odds ratio (OR) = 1.45, 95% CI: 0.74-2.84, p = 0.27, I2 = 54%]: stone formation (OR = 1.07, 95% CI: 0.51-2.23, p = 0.48, I2 = 0%), and renal function deterioration (OR = 0.81, 95% CI: 0.39-1.68, p = 0.57, I2 = 0%) between the TUU and IC groups. Quality of life decreased in both groups, and only occurred in the early days after the stoma placement phase. Survival rates were not different among the groups.
UNASSIGNED: TUU is a better UD option as it offers shorter time of hospitalization, with the similar major complications, quality of life, and survival rate compared to IC.