首页膀胱肿瘤治疗及预后证据详情

中药联合膀胱灌注治疗非肌层浸润性膀胱癌根治术后 Meta 分析

原文: 2020 年 发布于 Urology Journal 78 卷 第 4 期 1243-1254 浏览量:220次

作者: 张恺 鄢祺 阮善明

作者单位: Department of Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran. AKH.Alirezakhatami@gmail.com. Department of Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1016/j.eururo.2022.03.027

关键词: 膀胱肿瘤 膀胱切除术

文献简介

OBJECTIVE: To compare the efficacy and safety of transurethral laser surgery and transurethral resection of a bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC). MATERIAL AND METHODS: A research was carried out in Medline via PubMed, EMBASE, the Cochrane Library, and Web of Science up to October 20, 2019, to identify articles related to transurethral laser surgery and TURBT for NMIBC. All analyses were done using RevMan5.3 and Stata14. RESULTS: A total of 17 studies involving 2,439 participants were included. The analysis showed no significant difference in operation times (mean difference = -0.2; 95% CI -2.29 to 1.89; p = 0.85) or occurrences of urethral stricture (OR = 0.7; 95% CI 0.24-2.06; p = 0.52). Transurethral laser surgery was associated with a lower incidence of obturator nerve reflex (OR = 0.04; 95% CI 0.02-0.09; p < 0.00001) and bladder perforation (OR = 0.09; 95% CI 0.04-0.23; p < 0.00001), a higher rate of detrusor muscle acquisition (OR = 5.28; 95% CI 2.42-11.49; p < 0.0001), shorter catheterization (mean difference = -1.05; 95% CI -1.41 to -0.68; p < 0.00001) and hospitalization times (mean difference = -0.96; 95% CI -1.59 to -0.33; p = 0.003), and lower rates of bladder irrigation (OR = 0.21; 95% CI 0.13-0.35; p < 0.00001) and recurrence both at 12 months (OR = 0.66; 95% CI 0.48-0.9, p = 0.008) and at 24 months (OR = 0.6; 95% CI 0.41-0.86; p = 0.005). CONCLUSIONS: Transurethral laser surgery for NMIBC, as compared to TURBT, is associated with a lower incidence of complications, a lower recurrence rate, and faster postoperative recovery.

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