Content area

Abstract

Cystectomy is the gold standard treatment for muscle invasive bladder cancer. Robotic cystectomy has become increasingly popular owing to quicker post- operative recovery, less blood loss and less post-operative pain. Urinary diversion is increasingly being performed with an intracorporeal technique. Uretero-enteric strictures (UES) cause significant morbidity for patients. UES for open cystectomy is 3–10%, but the range is much wider (0–25%) for robotic surgery. We aim to perform systematic review for studies comparing all 3 techniques, to assess for ureteric stricture rates. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement (Page et al. in BMJ 29, 2021). PubMed, Scopus and Embase databases were searched for the period January 2003 to June 2023 inclusive for relevant publications.The primary outcome was to identify ureteric stricture rates for studies comparing open cystectomy and urinary diversion, robotic cystectomy with extracorporeal urinary diversion (ECUD) and robotic cystectomy with intracorporeal urinary diversion (ICUD). Three studies were identified and included 2185 patients in total. The open operation had the lowest stricture rate (9.6%), compared to ECUD (12.4%) and ICUD (15%). ICUD had the longest time to stricture (7.55 months), ECUD (4.85 months) and the open operation (4.75 months). Open operation had the shortest operating time. The Bricker anastomoses was the most popular technique. Open surgery has the lowest rates of UES compared to both robotic operations. There is a learning curve involved with performing robotic cystectomy and urinary diversion, this may need to be considered to decide whether the technique is comparable with open cystectomy UES rates. Further research, including Randomised Control Trials (RCT), needs to be undertaken to determine the best surgical option for patients to minimise risks of UES.

Details

Business indexing term
Title
Systematic review comparing uretero-enteric stricture rates between open cystectomy with ileal conduit, robotic cystectomy with extra-corporeal ileal conduit and robotic cystectomy with intra corporeal ileal conduit formation
Publication title
Volume
18
Issue
1
Pages
100
Publication year
2024
Publication date
Dec 2024
Publisher
Springer Nature B.V.
Place of publication
Heidelberg
Country of publication
Netherlands
ISSN
18632483
e-ISSN
18632491
Source type
Scholarly Journal
Language of publication
English
Document type
Evidence Based Healthcare, Journal Article
Publication history
 
 
Online publication date
2024-02-28
Milestone dates
2024-01-28 (Registration); 2024-01-18 (Received); 2024-01-28 (Accepted)
Publication history
 
 
   First posting date
28 Feb 2024
ProQuest document ID
2938254112
Document URL
https://www.proquest.com/scholarly-journals/systematic-review-comparing-uretero-enteric/docview/2938254112/se-2?accountid=208611
Copyright
Copyright Springer Nature B.V. Dec 2024
Last updated
2025-02-23
Database
ProQuest One Academic