Systematic Literature Review of Laparoscopic Radical Cystectomy in Bladder Cancer

By Patrick Daly - Last Updated: March 9, 2022

In a meta-analysis, published in Translational Andrology and Urology, researchers evaluated the safety and efficacy of laparoscopic radical cystectomy (LRC) surgical therapy in patients with bladder cancer (BC). The study’s authors, led by Jialiang Zhu, concluded that “LRC treatment of BC could effectively reduce the amount of [intraoperative blood loss (IBL)], and lower the intraoperative [blood transfusion rate (BTR)], use of analgesics, and incidence of postoperative complications.”

The investigators included 12 total articles, covering 1,283 patients, from clinical controlled trials on LRC surgery for treating patients with BC. Cochrane Handbook and Review Manager tools were utilized to conduct the primary meta-analysis, as well as assess the risk of bias across the included articles.

According to the study’s report, the intervention group patients had significantly lower IBL after LRC compared to the control group patients (mean difference [MD] = –458.75; 95% confidence interval [CI], –505.75 to –411.76; Z = 2.08; p < 0.00001). As noted, the LRC intervention also demonstrated significantly improved measures in BTR (odds ratio [OR] = 0.36; 95% CI, 0.13–0.94; Z = 2.08; p = 0.04), use of analgesics (MD = –24.53; 95% CI, –39.04 to –10.01; Z = 3.31; p = 0.0009), and incidence of postoperative complications (Risk ratio = 0.58; 95% CI, 0.39–0.85; Z=2.77; p = 0.006). However, the length of hospital stay was not significantly shortened (MD = –2.43; 95% CI, –4.83 to –0.02; Z = 1.98; p = 0.05).

Given the observed advantages of LRC surgical therapy versus non-LRC control groups among the included studies, the collaborating researchers concluded that LRC could be used to treat patients with BC. In closing, they recommended that “more high-quality, multi-center, large-sample clinical controlled trials should be performed to further analyze the surgical effect of LRC in the treatment of BC, so as to provide an adequate basis for the treatment of BC.”

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