BACKGROUND: To compare intracorporeal urinary diversion (ICUD) with extracorporeal urinary diversion (ECUD) after robot-assisted radical cystectomy (RARC) for surgery safety, postoperative recovery, complication, and prognosis. METHODS: We performed a literature search on PubMed, Embase, Medline and the Cochrane Library based on all randomized controlled trials (RCTs) and observational comparative studies related to study topics published before July 14th, 2020. Then systematic review and meta-analysis was performed. RESULTS: 13 retrospective studies containing 4,755 patients were identified. In terms of surgery safety, with similar operative time, ICUD group showed less estimated blood loss (EBL) (P<0.0001) and lower blood transfusion rate (P=0.006). In terms of postoperative recovery, with similar hospital stay, ICUD group showed earlier recovery on flatus (P<0.001) and oral intake (P<0001). In aspect of complications, there were no significant differences between ICUD and ECUD groups, except for gastrointestinal system complications. ICUD group had lower gastrointestinal complications rate than ECUD group (P=0.002). In aspect of prognosis outcomes, with similar mortality, ICUD group had lower recurrence rate than ECUD group (P=0.004). CONCLUSIONS: Based on the current evidence, ICUD procedure is excellence in surgery safety, postoperative recovery, complications, and prognosis. However, the observational studies reduced the level of evidence, larger randomized trials are needed to confirm these findings. 2021 Gland Surgery. All rights reserved.
BACKGROUND: To compare intracorporeal urinary diversion (ICUD) with extracorporeal urinary diversion (ECUD) after robot-assisted radical cystectomy (RARC) for surgery safety, postoperative recovery, complication, and prognosis. METHODS: We performed a literature search on PubMed, Embase, Medline and the Cochrane Library based on all randomized controlled trials (RCTs) and observational comparative studies related to study topics published before July 14th, 2020. Then systematic review and meta-analysis was performed. RESULTS: 13 retrospective studies containing 4,755 patients were identified. In terms of surgery safety, with similar operative time, ICUD group showed less estimated blood loss (EBL) (P<0.0001) and lower blood transfusion rate (P=0.006). In terms of postoperative recovery, with similar hospital stay, ICUD group showed earlier recovery on flatus (P<0.001) and oral intake (P<0001). In aspect of complications, there were no significant differences between ICUD and ECUD groups, except for gastrointestinal system complications. ICUD group had lower gastrointestinal complications rate than ECUD group (P=0.002). In aspect of prognosis outcomes, with similar mortality, ICUD group had lower recurrence rate than ECUD group (P=0.004). CONCLUSIONS: Based on the current evidence, ICUD procedure is excellence in surgery safety, postoperative recovery, complications, and prognosis. However, the observational studies reduced the level of evidence, larger randomized trials are needed to confirm these findings. 2021 Gland Surgery. All rights reserved.
Authors: Timothy G Wilson; Khurshid Guru; Raymond C Rosen; Peter Wiklund; Magnus Annerstedt; Bernard H Bochner; Kevin G Chan; Francesco Montorsi; Alexandre Mottrie; Declan Murphy; Giacomo Novara; James O Peabody; Joan Palou Redorta; Eila C Skinner; George Thalmann; Arnulf Stenzl; Bertram Yuh; James Catto Journal: Eur Urol Date: 2015-01-09 Impact factor: 20.096
Authors: Ahmed A Hussein; Paul R May; Zhe Jing; Youssef E Ahmed; Carl J Wijburg; Abdulla Erdem Canda; Prokar Dasgupta; Mohammad Shamim Khan; Mani Menon; James O Peabody; Abolfazl Hosseini; John Kelly; Alexandre Mottrie; Jihad Kaouk; Ashok Hemal; Peter Wiklund; Khurshid A Guru Journal: J Urol Date: 2017-12-21 Impact factor: 7.450
Authors: Alessandro Liberati; Douglas G Altman; Jennifer Tetzlaff; Cynthia Mulrow; Peter C Gøtzsche; John P A Ioannidis; Mike Clarke; P J Devereaux; Jos Kleijnen; David Moher Journal: BMJ Date: 2009-07-21
Authors: Ji Sung Shim; Tae Gyun Kwon; Koon Ho Rha; Young Goo Lee; Ji Youl Lee; Byong Chang Jeong; Jong Hyun Pyun; Sung Gu Kang; Seok Ho Kang Journal: Investig Clin Urol Date: 2019-12-18