首页膀胱肿瘤治疗及预后证据详情

Robotic Versus Open Cystectomy for Bladder Cancer: Synthesizing the Data from Current Systematic Reviews and Meta-Analyses

原文: 2023 年 发布于 Ann Surg Oncol 40 卷 第 8 期 186-195 浏览量:259次

作者: Aminoltejari K. Hird A. E. Klaassen Z. Satkunasivam R. Kulkarni G. S. Luckenbaugh A. N. Laviana A. A. Wallis C. J. D. Clark R.

作者单位: Department of Urology, Medical University of Vienna, 1090 Vienna, Austria. Department of Urology, The Jikei University School of Medicine, Tokyo 3-25-8, Japan. Department of Urology, University of Jordan, Amman 11942, Jordan. Department of Urology, Luzerner Kantonsspital, 6000 Luzern, Switzerland. Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria. Comprehensive Cancer Center, Department of Urology, Medical University of Vienna, 1090 Vienna, Austria. Institute of Urology and Reproductive Health, Imperial Moscow Sechenov First Moscow State Medical University, 119992 Moscow, Russia. Department of Urology, Weill Cornell Medical College, New York, NY 10065, USA. Department of Urology, University of Texas Southwestern, Dallas, TX 5323, USA. Karl Landsteiner Institute of Urology and Andrology, 1090 Vienna, Austria. Department of Urology, Second Faculty of Medicine, Charles University, 150 06 Prague, Czech Republic. European Association of Urology Research Foundation, 6803 Arnhem, The Netherlands.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.27295/d.cnki.gstou.2021.000541

关键词: 超声造影 增强CT 膀胱肿瘤 Meta分析

文献简介

This is a summary of existing systematic reviews comparing robotic assisted radical cystectomy (RARC) with open radical cystectomy (ORC). Our aim was to compare operative approaches with respect to perioperative, postoperative, oncologic, and health-related quality of life (QOL) outcomes. We performed a systematic review of MEDLINE, Medline-in-Process and Medline Epubs Ahead of Print, and the Cochrane Library on 22 February 2022. We included reviews of adult patients with bladder cancer undergoing RARC or ORC for muscle invasive or high-risk non-muscle invasive bladder cancer. Nonrandomized studies were excluded to minimize confounding and selection bias. The GRADE approach was used to determine the confidence in estimates. We assessed the quality of identified systematic reviews using AMSTAR 2 checklist. Six well-conducted, systematic reviews and meta-analyses were included. RARC was consistently associated with lower estimated blood loss (EBL) and transfusion rates, and longer operative time. There was inconsistent evidence for the impact of RARC on hospital length of stay (LOS). There was no significant difference in overall complication rate or major complication rate, or oncologic outcomes between groups. Comparison of QOL outcomes between studies was limited by statistical and methodological heterogeneity. RARC is associated with improvement in EBL and transfusion risk. There does not appear to be differences in oncologic outcomes or complications between approaches. Prospective studies are needed to assess the impact of diversion type, technique, and recovery pathways on patient outcomes and to assess the impact of operative approach on cost and patient-reported QOL.

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