Laparoscopic versus open nephroureterectomy for upper urinary tract urothelial carcinoma A systematic review and meta-analysis

被引：28
作者：
Liu, Feng [1 ]
Guo, Wei [2 ]
Zhou, Xueying [3 ]
Ding, Youpeng [4 ]
Ma, Yanan [4 ]
Hou, Yi [4 ]
Kong, Xiangbo [4 ]
Wang, Zhixin [4 ]
机构：
[1] Jilin Univ, China Japan Union Hosp, Dept Nephrol, Changchun, Jilin, Peoples R China
[2] Jilin Univ, China Japan Union Hosp, Dept Out Patient, Changchun, Jilin, Peoples R China
[3] Jilin Univ, China Japan Union Hosp, Dept Operat Room, Changchun, Jilin, Peoples R China
[4] Jilin Univ, China Japan Union Hosp, Dept Urol, Changchun 130033, Jilin, Peoples R China
来源：
MEDICINE | 2018年 / 97卷 / 35期
关键词：
laparoscopic nephroureterectomy; meta-analysis; open nephroureterectomy; urinary tract urothelial carcinoma; OPEN RADICAL NEPHROURETERECTOMY; TRANSITIONAL-CELL CARCINOMA; INTRAVESICAL RECURRENCE; ONCOLOGICAL OUTCOMES; RISK-FACTORS; CANCER; SURVIVAL; BLADDER; NEPHRECTOMY; EXCISION;
D O I：
10.1097/MD.0000000000011954
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Purpose: To evaluate the efficacy and safety of laparoscopic nephroureterectomy (LNU) and open nephroureterectomy (ONU) for the treatment of upper urinary tract urothelial carcinoma (UTUC). Methods: PubMed, Embase, and Cochrane databases were selected for systematic review of trials that compared outcomes of LNU and ONU. Meta-analysis was performed using RevMan 5.3 and STATA 13.0 software. Results: LNU was associated with longer operation time (P<.001), shorter hospital stay (P<.001), less blood loss (P=.006) and lower rate of transfusion (P<.001). The occurrence of complications, including minor (P=.52), major (P=.21) and total complications (P=.19) were similar between LNU and ONU. There was no significant difference in the rate of 5-year recurrence-free survival (P=.90), 5-year cancer-specific survival (P=.12), and 5-year overall survival (P=.11) as well as 2-year RFS (P=.84), 2-year CSS (P=.86), and 2-year OS (P=.25). Conclusion: Our results indicated that LNU is a safe and effective method to treat UTUC. Given the limitations of this study, further multicenter, randomized trials are required to confirm these findings.
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