非肌层浸润性膀胱癌术后卡介苗诱导治疗与诱导加维持治疗效果的系统评价与 Meta 分析

原文： 2021 年发布于 European Urology 27 卷第 2 期 143-152  浏览量：320次

作者单位： Division of Surgery and Interventional Science, University College London, London, UK Department of Urology, University College London Hospital, London, UK. Electronic address: p.khetrapal@ucl.ac.uk. Division of Surgery and Interventional Science, University College London, London, UK Department of Urology, University College London Hospital, London, UK. Department of Urology, University College London Hospital, London, UK. Department of General Surgery, University College London Hospital, London, UK. Department of Radiology, University College London Hospital, London, UK. Department of Histopathology, University College London Hospital, London, UK. Department of Oncology, University College London Hospital, London, UK.

归属分类：膀胱肿瘤治疗及预后证据

DOI： 10.26914/c.cnkihy.2018.012668

关键词： Quality of life (QoL) bladder cancer non-muscle invasive bladder cancer (NMIBC) surveillance form (available at http://dx.doi.org/10.21037/tau-20-1333). The series “Expectant Management in Genitourinary Malignancies (Prostate Bladder Kidney)” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare.

PURPOSE: To systematically review studies comparing the perioperative outcomes of intracorporeal robot-assisted radical cystectomy (iRARC) and open radical cystectomy (ORC). METHODS: Systematic searches of PubMed, Web of Science and the Cochrane Library were performed in June 2020. Studies with data comparing iRARC and ORC were included in our review, and a pooled meta-analysis was completed. RESULTS: In total, 8 studies (7 prospective studies, 1 retrospective study) comparing 1193 patients were included for our review and meta-analysis. Compared with ORC, iRARC demonstrated lower estimated blood loss (weighted mean difference (WMD): -449.25; 95% CI -566.47 - -332.03; p < 0.01), lower blood transfusion rates (OR: 0.31; 95% CI 0.22 - 0.46; p < 0.01), and lower postoperative complication rates with Clavien-Dindo grades III-IV (30 days: OR: 0.65; 95% CI 0.47 - 0.90; p = 0.01; 90 days: OR: 0.72; 95% CI 0.53 - 0.98; p = 0.04), but a longer operative time (WMD: 78.82; 95% CI 52.77 - 104.87; P < 0.01). Furthermore, there was no significant difference between iRARC and ORC in terms of postoperative complication rates with Clavien-Dindo grades Ⅰ - Ⅱ (30 days: OR: 0.71; 95% CI 0.36 - 1.40; p = 0.32; 90 days: OR: 0.98; 95% CI 0.74 - 1.30; p = 0.89), length of stay (WMD: -1.18; 95% CI -3.33 - -2.07; p = 0.06) and positive surgical margins (OR: 0.78; 95% CI 0.0.45 - 1.36; p = 0.38). CONCLUSION: iRARC was associated with a significantly lower estimated blood loss and a lower blood transfusion rate and major postoperative complication rate than ORC.