Postoperative C-reactive protein concentration and clinical outcome: comparison of open cystectomy to robot-assisted laparoscopic cystectomy with extracorporeal or intracorporeal urinary diversion in a prospective study

Kingo, Pernille Skjold; Nørregaard, Rikke; Borre, Michael; Jensen, Jørgen Bjerggaard

doi:10.1080/21681805.2017.1334698

Cited by 16 publications

(14 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We identified 298 studies in PubMed, 1659 studies in Web of Science, and 31 studies in Scopus from the initial search; 2 additional studies were added after the latest search. After removing 219 duplicate articles, we screened 1771 titles and abstracts, reviewed 145 full-text articles, which led to the identification of 12 articles comprising 3067 patients that met our inclusion/exclusion criteria [18,[20][21][22][23][24][25][26][27][28][29][30]. Five articles were excluded because of an overlap in the recruitment period at the same institution (Fig.…”

Section: Search Resultsmentioning

confidence: 99%

“…patients ICUD/ECUD Age, mean (y) ICUD/ECUD Male (%) BMI ICUD/ECUD NAC rate (%) ICUD/ECUD ASA score > 3 (%) No. of surgeons Hospital volume in ICUD, n (/y) Pruthi et al [ 28 ] 2008–2009 USA Retrospective 12/20 61/67 75/70 28/27 NR NR NR 3.3 Aboumohamed et al [ 29 ] 2009–2012 USA Retrospective 42/120 70/68 79/72 31/28 NR 50/58.6 NR 10.5 Pyun et al [ 26 ] 2007–2014 South Korea Retrospective 26/38 65/63 92/92 25/25 23.1/18.4 NR 1 3.3 Kingo et al [ 27 ] 2012–2015 Denmark Prospective 38/12 68/68 82/83 27/24 34.2/0 5.3/16.7 5 9.5 Lenfant et al [ 20 ] 2010–2016 …”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2021

View full text Add to dashboard Cite

This systematic review and meta-analysis aimed to assess and compare the perioperative and oncological outcomes of intracorporeal (ICUD) and extracorporeal (ECUD) urinary diversion following robot-assisted radical cystectomy (RARC). A systematic literature search of articles was performed in PubMed®, Web of Science®, and Scopus® databases according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. We included studies that compared patients who underwent RARC with ICUD to those with ECUD. Twelve studies including 3067 patients met the eligibility criteria. There were no significant differences between ICUD and ECUD in overall and major complications, regardless of the period (short-term [≤ 30 days] or mid-term [> 30 days]). Subgroup analyses demonstrated that ICUD performed by high-volume centers exhibited a significantly reduced risk of major complications (short-term: OR 0.57, 95% CI 0.37–0.86, p = 0.008, mid-term: OR 0.66, 95% CI 0.46–0.94, p = 0.02). Patients who underwent ICUD had lower estimated blood loss (MD -102.3 ml, 95% CI − 132.8 to − 71.8, p < 0.00001), less likely to receive blood transfusion rates (OR 0.36, 95% CI 0.20–0.62, p = 0.00003); and these findings were consistent in subgroup analyses by low-volume centers (MD-121.6 ml, 95% CI − 160.9 to − 82.3, p < 0.00001 and OR 0.36, 95% CI 0.20–0.62, p = 0.00003, respectively). ICUD had a higher lymph node yield (MD 3.68, 95% CI 0.80–6.56, p = 0.01). Patients receiving ICUD provided comparable complications, superior perioperative outcomes, and similar oncological outcomes compared with ECUD. Centralization of patients may contribute to a reduction of postoperative complications, while maintaining the advantages.

show abstract

Section: Search Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The general characteristics of the eligible studies are summarized in Table . The present systematic review includes six RCTs comprising 581 patients, and 31 NRCTs comprising 48 392 patients published between 2010 and 2018. Of these, 20 studies enrolled patients from North America, nine from Europe and eight from Asia.…”

Section: Resultsmentioning

confidence: 99%

“…This reporting deviation from NRCTs could be due to a selection, reporting and/or detection bias in favor of RARC. For example, several studies included ORC patients with higher comorbidities, higher BMI and/or more advanced disease compared with those treated with RARC, which led to a selection bias benefiting RARC . Furthermore, when comparing novel interventions with conventional ones, there can be a novelty bias in NRCTs, which is a form of selection bias…”

Section: Discussionmentioning

confidence: 99%

Comparison of perioperative complications and health‐related quality of life between robot‐assisted and open radical cystectomy: A systematic review and meta‐analysis

et al. 2019

View full text Add to dashboard Cite

To compare postoperative complications and health‐related quality of life of patients undergoing robot‐assisted radical cystectomy with those of patients undergoing open radical cystectomy. A systematic search was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. A pooled meta‐analysis was carried out to assess the differences between robot‐assisted radical cystectomy and open radical cystectomy according to randomized and non‐randomized comparative studies, respectively. We identified six randomized comparative studies and 31 non‐randomized comparative studies. Most robot‐assisted radical cystectomy patients were treated with extracorporeal urinary diversion. Robot‐assisted radical cystectomy was associated with longer operative times, and lower blood loss and transfusion rates compared with open radical cystectomy in both randomized comparative studies and non‐randomized comparative studies. There was no significant difference between robot‐assisted radical cystectomy and open radical cystectomy in the rate of patients with any or major complications within 90 days both in randomized comparative studies and non‐randomized comparative studies. Non‐randomized comparative studies reported a lower rate of complications at 30 days, mortality at 90 days and length of stay for patients treated with robot‐assisted radical cystectomy, which were not confirmed in randomized comparative studies. Additionally, there were no differences in postoperative quality of life score assessment at 3 and 6 months between robot‐assisted radical cystectomy and open radical cystectomy. Robot‐assisted radical cystectomy is associated with less blood loss and lower transfusion rates. There is no difference in complications, length of stay, mortality, and quality of life between robot‐assisted radical cystectomy and open radical cystectomy. Data from non‐randomized comparative studies favor perioperative outcomes in robot‐assisted radical cystectomy patients, the failure to confirm in randomized comparative studies, likely due to bias in study design and reporting. Further randomized comparative studies comparing postoperative complications and quality of life between robot‐assisted radical cystectomy with intracorporeal urinary diversion and open radical cystectomy are required to assess potential differences between these two surgical approaches.

show abstract

“…On the basis of our inclusion and/or exclusion criteria, we ruled out 123 articles and then evaluated the full text of the remaining 40 studies. After further filtering with inclusion criteria, thirteen retrospective studies (6,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)) containing 4,755 cases were included in the final analysis. These studies were published between 2010 and 2020 with six been from America, four from Europe and three from South Korea.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Intracorporeal versus extracorporeal urinary diversion after robot‐assisted radical cystectomy: a pooled analysis

Cai¹,

Li²,

Hu³

et al. 2021

Gland Surg

View full text Add to dashboard Cite

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.

show abstract

Postoperative C-reactive protein concentration and clinical outcome: comparison of open cystectomy to robot-assisted laparoscopic cystectomy with extracorporeal or intracorporeal urinary diversion in a prospective study

Abstract: In this study, robotic techniques seem less traumatic overall than open surgery, as OMC had higher postoperative CRP levels than RALC-EUD. The higher CRP levels in RALC-IUD may be more reflective of the urinary diversion technique than the true tissue trauma.

Cited by 16 publications

References 31 publications

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

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

Comparison of perioperative complications and health‐related quality of life between robot‐assisted and open radical cystectomy: A systematic review and meta‐analysis

Intracorporeal versus extracorporeal urinary diversion after robot‐assisted radical cystectomy: a pooled analysis

Contact Info

Product

Resources

About