首页膀胱肿瘤治疗及预后证据详情

内镜黏膜下剥离术治疗非肌层浸润性膀胱肿瘤疗效单组率的 Meta 分析

原文: 2019 年 发布于 Gene 123 卷 第 4 期 924-936 浏览量:246次

作者: 高辉 李涛 傅崇德 刘晓彤 陈广瑜 焦林 魏乔红 汤尧 谢圣陶

作者单位: Department of Urology, Lanzhou University Second Hospital, Institute of Urology, Institute of Gansu Nephro-Urological Clinical Center, Key Laboratory of Urological Disease of Gansu Province, Lanzhou, China, stone_405@163.com. Department of Urology, Shantou Central Hospital, Shantou, China, stone_405@163.com. Department of Urology, Lanzhou University Second Hospital, Institute of Urology, Institute of Gansu Nephro-Urological Clinical Center, Key Laboratory of Urological Disease of Gansu Province, Lanzhou, China. Department of Urology, Shantou Central Hospital, Shantou, China.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1016/j.pdpdt.2022.103220

关键词: Adult Aged Aged 80 and over Female Humans *Magnetic Resonance Imaging Male Middle Aged *Neoplasm Staging/methods/standards Urinary Bladder Neoplasms/*diagnostic imaging bladder cancer diagnostic accuracy magnetic resonance imaging staging systematic review

文献简介

PURPOSE: The BCAN (Bladder Cancer Advocacy Network) Patient Survey Network identified pain during intravesical procedures as a research priority for patients. Although intraurethral lidocaine is the standard of care in this setting, evidence of its use is equivocal. We systematically reviewed studies of interventions to reduce discomfort during cystoscopy and intravesical therapy of bladder cancer. We performed a meta-analysis of interventions using available randomized, controlled trials. MATERIALS AND METHODS: Search terms derived from the key questions were incorporated into the literature search constructed by a research librarian and the English medical literature from 1990 to 2017 was accessed. The initial search yielded 626 potential studies and the final review incorporated 62. We combined 12 trials into a meta-analysis with a random effects model of the efficacy of intraurethral lidocaine vs plain lubricant to reduce pain during flexible cystoscopy as measured on a 10-point visual analogue scale. RESULTS: Data from 12 randomized controlled trials in a total of 1,549 patients were included in the final intraurethral lidocaine meta-analysis. The standardized mean difference between visual analogue scale pain scores in patients who underwent flexible cystoscopy with intraurethral lidocaine and plain lubricant was -0.22 (95% CI -0.39--0.05). Evidence was insufficient to evaluate other interventions to mitigate the discomfort of invasive bladder procedures. CONCLUSIONS: Intraurethral lidocaine provides statistically significant pain reduction in men who undergo flexible cystoscopy, particularly with a longer dwell time. The evidence was insufficient for other tested interventions. A prospective study is needed to further clarify interventions to decrease patient discomfort during cystoscopy and other intravesical procedures in a diverse population.

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