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22.11.2020 | Review Article

Intracorporeal versus extracorporeal urinary diversion following robot-assisted radical cystectomy: a meta-analysis, cumulative analysis, and systematic review

verfasst von: Karthik Tanneru, Seyed Behzad Jazayeri, Jatinder Kumar, Muhammad Umar Alam, Daniel Norez, Sabine Nguyen, Soroush Bazargani, Hariharan Palayapalayam Ganapathi, Mark Bandyk, Robert Marino, Shahriar Koochekpour, Shiva Gautam, K. C. Balaji, Joseph Costa

Erschienen in: Journal of Robotic Surgery | Ausgabe 3/2021

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Abstract

Over the last decade, the increased utilization of robot-assisted radical cystectomy (RARC) in the surgical treatment of muscle-invasive bladder cancer has led to an uptrend in intracorporeal urinary diversions (ICUD). However, the operative results comparing ICUD to extracorporeal urinary diversion (ECUD) have varied widely. We performed a meta-analysis to analyze perioperative outcomes and complications of ICUD compared to ECUD following RARC. This study is registered at International Prospective Register of Systematic Reviews (PROSPERO) CRD42020164074. A systematic literature review was conducted using PubMed, EMBASE, and Cochrane databases in August 2019. A total of six studies comparing ICUD vs ECUD were identified and meta-analysis was conducted on these studies. In addition, a cumulative analysis was also performed on 83 studies that reported perioperative outcomes after RARC and ICUD or ECUD. The Weighed Mean Difference of operative time and blood loss between ICUD and ECUD group was (16; 95% confidence interval − 34 to 66) and (− 86; 95% confidence interval − 124 to − 48), respectively. ICUD and ECUD had comparable early (30-day) and mid-term (30–90-day) complication rate (RR 1.19; 95% confidence interval 0.71–2.0; p = 0.5) and (RR 0.91; 95% confidence interval 0.71–1.15 p = 0.4) respectively. In the 83 studies that were included in the cumulative analysis, the mean operative time for ileal conduit and neobladders by ICUD were 307 and 428 min, respectively, compared to ECUD 428 and 426 min, respectively. ICUD and ECUD have comparable short- and mid-term complication rate. The ICUD group has lower blood loss and lower rate of blood transfusion compared to ECUD.

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Titel: Intracorporeal versus extracorporeal urinary diversion following robot-assisted radical cystectomy: a meta-analysis, cumulative analysis, and systematic review
verfasst von: Karthik Tanneru
Seyed Behzad Jazayeri
Jatinder Kumar
Muhammad Umar Alam
Daniel Norez
Sabine Nguyen
Soroush Bazargani
Hariharan Palayapalayam Ganapathi
Mark Bandyk
Robert Marino
Shahriar Koochekpour
Shiva Gautam
K. C. Balaji
Joseph Costa
Publikationsdatum: 22.11.2020
Verlag: Springer London
Erschienen in: Journal of Robotic Surgery / Ausgabe 3/2021
Print ISSN: 1863-2483
Elektronische ISSN: 1863-2491
DOI: https://doi.org/10.1007/s11701-020-01174-4

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