Laparoscopic radical cystectomy versus open radical cystectomy for the treatment of muscle invasive bladder cancer：a meta-analysis
10.3760/cma.j.issn.1000-6702.2015.10.012
- VernacularTitle:腹腔镜下与开放式根治性膀胱切除术临床疗效及安全性的荟萃分析
- Author:
Qingsong ZENG
;
Yajun XIAO
- Publication Type:Journal Article
- Keywords:
Urinary bladder neoplasms;
Laparoscopes;
Open surgery;
Meta-analysis
- From:
Chinese Journal of Urology
2015;(10):768-773
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the effectiveness and safety of laparoscopic radical cystectomy (LRC) versus open radical cystectomy (ORC).Methods The databases of Cochrane Library , PubMed, EMbase, SCI, Ovid, CBM, WanFang Data Knowledge Service Platform , VIP Information Chinese Science and China National Knowledge Infrastructure , were searched to collect the randomized controlled trails ( RCTs) and non-RCTs about LRC versus ORC for the treatment of muscle invasive bladder cancer . The retrieval time span was from inception to May 2013.The studies were screened according to the inclusion and exclusion criteria , the data were extracted and the quality was evaluated by 2 reviewers independently.The meta-analysis was conducted using RevMan 5.2.6 software.Results A total of 13 non-RCTs involving 783 patients were included .The meta-analysis showed that comparing with ORC , LRC had lesser intraoperative blood loss [MD =-466.85,95%CI( -603.33, -330.37), P <0.001], lower transfusion rate [OR =0.27, 95%CI(0.18, 0.41),P <0.001], shortening postoperative hospital stay [MD=-3.46, 95%CI(-5.98,-0.94), P=0.007], shortening time to oral intake [MD=-1.16, 95%CI(-1.41, -0.90), P<0.001], lesser minor complications [OR=0.52, 95%CI(0.30, 0.89), P=0.020], lower positive margins [OR=0.25, 95%CI(0.10,0.58),P=0.001], lower positive lymphs [OR=0.61, 95%CI(0.40, 0.92),P=0.020], but longer operative time[MD=52.44, 95%CI(36.67, 68.21), P<0.001].There were no significant differences between LRC and ORC in lymph node yield , local recurrence and distant metastases ( P>0.05 ) .Conclusions LRC is safe and feasible for treating muscle invasive bladder cancer when its indications are strictly controlled .However, for the quantity and quality limitation of the involved studies , this conclusion still requires to be further proved by large and high quality studies.
