首页膀胱肿瘤治疗及预后证据详情

新辅助化疗保留膀胱与根治性手术治疗浸润性膀胱癌的 Meta 分析

原文: 2018 年 发布于 Clin Rehabil 4 卷 第 3 期 817-825 浏览量:188次 原文链接

作者: 李俊勇 文艳

作者单位: Department of Urology, Hospital Universitario La Paz, Madrid, Spain. Department of Urology, Policlinico San Martino Hospital, University of Genova, Genoa, Italy.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1186/s13027-022-00415-5

关键词: 围手术期输血 膀胱癌手术 系统评价 Meta分析

文献简介

BACKGROUND: Our understanding of effective perioperative supportive interventions for patients undergoing cystectomy procedures and how these may affect short and long-term health outcomes is limited. METHODS: Randomised controlled trials involving any non-surgical, perioperative interventions designed to support or improve the patient experience for patients undergoing cystectomy procedures were reviewed. Comparison groups included those exposed to usual clinical care or standard procedure. Studies were excluded if they involved surgical procedure only, involved bowel preparation only or involved an alternative therapy such as aromatherapy. Any short and long-term outcomes reflecting the patient experience or related urological health outcomes were considered. RESULTS: Nineteen articles (representing 15 individual studies) were included for review. Heterogeneity in interventions and outcomes across studies meant meta-analyses were not possible. Participants were all patients with bladder cancer and interventions were delivered over different stages of the perioperative period. The overall quality of evidence and reporting was low and outcomes were predominantly measured in the short-term. However, the findings show potential for exercise therapy, pharmaceuticals, ERAS protocols, psychological/educational programmes, chewing gum and nutrition to benefit a broad range of physiological and psychological health outcomes. CONCLUSIONS: Supportive interventions to date have taken many different forms with a range of potentially meaningful physiological and psychological health outcomes for cystectomy patients. Questions remain as to what magnitude of short-term health improvements would lead to clinically relevant changes in the overall patient experience of surgery and long-term recovery.

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