首页膀胱肿瘤治疗及预后证据详情

椎管内麻醉下闭孔神经阻滞辅助经尿道膀胱肿瘤切除术的 Meta 分析

原文: 2020 年 发布于 Urol Int 3 卷 第 2 期 1165-1174 浏览量:156次

作者: 赵犁天 冯德超 刘圣琢 杨玉帛 白云金 韩平 魏武然

作者单位: Department of Family and Community Medicine, College of Medicine, Taibah University, P.O. Box 42317, Madinah, 41541, Saudi Arabia. Department of Complex Genetics, School of Nutrition, and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre, P. O. Box 616, 6200 MS, Maastricht, The Netherlands. k.stewart@maastrichtuniversity.nl. Department of Complex Genetics, School of Nutrition, and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre, P. O. Box 616, 6200 MS, Maastricht, The Netherlands. Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre, P. O. Box 616, 6200 MS, Maastricht, The Netherlands.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1016/j.eururo.2018.09.001

关键词: 新辅助化疗 肌层浸润性膀胱癌 Meta分析

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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