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Luo H, Xiong Y. Comparing surgical site wound infection after laparoscopic and open radical cystectomies in patients with bladder cancer. Int Wound J 2024; 21:e14718. [PMID: 38571455 PMCID: PMC10993015 DOI: 10.1111/iwj.14718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 04/05/2024] Open
Abstract
This study comprehensively compared the effects of laparoscopic and open radical cystectomies on postoperative wound infections and complications in patients with bladder cancer. We conducted a systematic search for relevant studies in PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases, from database inception to October 2023. Two researchers independently screened the literature, extracted data, and assessed the quality based on the inclusion and exclusion criteria. Data analysis was performed using Stata 17.0 software. Overall, 16 studies involving 1427 patients with bladder cancer were included. The analysis revealed that, compared with open radical cystectomy, laparoscopic radical cystectomy significantly reduced the incidence of wound infections (odds ratio [OR] = 0.38, 95% confidence interval [CI]: 0.23-0.64, p < 0.001) and complications (OR = 0.35, 95%CI: 0.26-0.47, p < 0.001) and significantly shortened the hospital stay duration (standardised mean difference [SMD] = -1.85, 95%CI: -2.34 to -1.36, p < 0.001). Thus, this study determined that laparoscopic radical cystectomy for the treatment of bladder cancer effectively reduced the occurrence of wound infections and complications, and significantly shortened the patient's hospital stay, demonstrating notable therapeutic effectiveness worthy of clinical application.
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Affiliation(s)
- Hua‐Ming Luo
- Department of UrologyYongchuan Hospital of Chongqing Medical UniversityChongqingChina
| | - Yong‐Jiang Xiong
- Department of UrologyYongchuan Hospital of Chongqing Medical UniversityChongqingChina
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Dong L, Xiaoli F, Ya L, Dan W, Jingwen H, Xun L, Shujin C, Zhijun Z, Tian Z, Hao L, Chuanlang Y, Guangrong C, Xiaodong W, Gewen L, Yichi Z, Pei C, Yang L, Youliang W. Bayesian network analysis of long-term oncologic outcomes of open, laparoscopic, and robot-assisted radical cystectomy for bladder cancer. Medicine (Baltimore) 2022; 101:e30291. [PMID: 36042614 PMCID: PMC9410639 DOI: 10.1097/md.0000000000030291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To understand the long-term oncologic outcomes of open radical cystectomy (ORC) versus laparoscopic radical cystectomy (LRC) versus robot-assisted radical cystectomy (RARC) for bladder cancer (BCa). Therefore, we performed the conventional meta-analysis and network meta-analysis to evaluate the long-term oncologic outcomes of ORC, LRC, and RARC for BCa. METHODS A systematic search of PubMed, Embase, Cochrane Library, Medline, and Web of science was performed up until July 1, 2021. Long-term oncologic outcomes include the 5-year overall survival (OS) rate, the 5-year recurrence-free survival (RFS) rate, and the 5-year cancer specific-survival (CSS) rate. The Bayesian network analysis has been registered in PROSPERO (CRD42020208396). RESULTS We found that 10 articles (including 3228 patients) were included in our Bayesian network analysis. No significant differences were found between ORC, LRC, and RARC in long-term oncologic outcomes in either direct meta-analysis or network meta-analysis. Therefore, the clinical effects of 5-year OS, RFS, and CSS of RARC, LRC, and ORC are similar. But LRC may be ranked first in 5-year OS, RFS, and CSS compared to other surgical approaches by probabilistic analysis ranking via Bayesian network analysis. CONCLUSION We found that there were no statistical differences in the 3 surgical approaches of RAPC, LPC, and OPC for Bca in long-term oncologic outcomes by direct meta-analysis. However, Subtle differences between these surgical approaches can be concluded that LRC may be a better surgical approach than RARC or ORC in long-term oncologic outcomes by probabilistic analysis ranking via Bayesian network analysis. Moreover, we need a large sample size and more high-quality studies to improve and verify further.
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Affiliation(s)
- Lin Dong
- Department of Urology, Pengzhou People’s Hospital, Chengdu, Sichuan, China
| | - Feng Xiaoli
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Lu Ya
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Wu Dan
- Department of Urology, Pengzhou People’s Hospital, Chengdu, Sichuan, China
| | - Hu Jingwen
- ICU, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Liu Xun
- Department of Urology, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Chen Shujin
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Zhou Zhijun
- Department of Urology, Pengzhou People’s Hospital, Chengdu, Sichuan, China
| | - Zhang Tian
- Department of Urology, Pengzhou People’s Hospital, Chengdu, Sichuan, China
| | - Luo Hao
- Department of Urology, Pengzhou People’s Hospital, Chengdu, Sichuan, China
| | - Yi Chuanlang
- Department of Urology, Pengzhou People’s Hospital, Chengdu, Sichuan, China
| | - Chen Guangrong
- Department of Anesthesiology (Operating Room), Pengzhou People’s Hospital, Chengdu, Sichuan, China
| | - Wang Xiaodong
- Department of Orthopedics, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Luo Gewen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Zhang Yichi
- Department of Gastrointestinal Surgery, Pengzhou People’s Hospital, Chengdu, Sichuan, China
| | - Cao Pei
- Department of Urology, Pengzhou People’s Hospital, Chengdu, Sichuan, China
| | - Liu Yang
- Department of Urology, Pengzhou People’s Hospital, Chengdu, Sichuan, China
| | - Wang Youliang
- Department of Laboratory, Pengzhou People’s Hospital, Chengdu, Sichuan, China
- *Correspondence: Wang Youliang, Department of Laboratory, Pengzhou People’s Hospital, Chengdu, Sichuan 611930, China (e-mail: )
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Effect of Radical Laparoscopic Surgery and Conventional Open Surgery on Surgical Outcomes, Complications, and Prognosis in Elderly Patients with Bladder Cancer. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1681038. [PMID: 35832525 PMCID: PMC9273384 DOI: 10.1155/2022/1681038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/30/2022] [Accepted: 06/06/2022] [Indexed: 01/24/2023]
Abstract
Background Bladder cancer is a common malignant tumor of the urinary system in the clinic. It has multiple lesions, easy recurrence, easy metastasis, poor prognosis, and high mortality. Objective The aim of this study is to investigate the impact of laparoscopic radical cystectomy (LRC) and open radical cystectomy (ORC) on the surgical outcome, complications, and prognosis of elderly patients with bladder cancer. Materials and Methods One hundred elderly bladder cancer patients who underwent surgery in our hospital from June 2019 to June 2021 were selected for the retrospective study and were divided into 50 cases each in the ORC group and the LRC group according to the different surgical methods. The ORC group was treated with ORC, and the LRC group implemented LRC treatment. The differences in surgery, immune function, recent clinical outcomes, and complications between the two groups were observed and compared. Results The mean operative time, mean intraoperative bleeding, intraoperative and postoperative transfusion rate, and transfusion volume of patients in the LRC group were statistically significant when compared to the ORC group. The differences in the meantime to resume eating, time to get out of bed, mean number of days in hospital after surgery, and the amount of postoperative numbing analgesics used by patients in the LRC group after surgery were statistically significant compared to the ORC group (P < 0.05). There was no statistically significant difference in the comparison of immune function between the two groups before surgery (P > 0.05), while the comparison of CD8+ and B cells 1 week after surgery of the LRC group was significantly better than that of the ORC group (P < 0.05), and the operation time of the LRC group was longer than that of the ORC group (P < 0.05). Statistical analysis of postoperative complications showed that the overall incidence of postoperative complications in the LRC group was significantly lower than that in the ORC group (16.67% vs. 46.67%) (P < 0.05). Conclusion LRC has less surgical trauma and intraoperative bleeding, faster postoperative recovery, and fewer postoperative complications, providing some reference for clinical surgery for elderly bladder cancer patients.
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