Meta-analysis Of Laparoscopic And Open Surgical Treatment Of Upper Urinary Tract Urothelial Cell Carcinoma

Objective:Through the meta-analysis method, the comprehensive evaluation of laparosc-opic surgery(LNU) and traditional open surgery(ONU),the two procedures in the treatme-nt of upper urinary tract urothelial cell carcinoma of the efficacy and safety of surgical time, blood loss, the amount of recovery time of gastrointestinal function,postoperative indwelling catheter time,hospital stay,postoperative bladder recurrence,distant metastasis a-fter surgery and5-year survival analysis and evaluation,for the clinical treatment of upp-er urinary tract urothelial cells the cancer has played some guiding significance.Methods:Collect world-wide application of laparoscopic surgery and open surgery for upper urinary tract transitional cell carcinoma of randomized controlled trials (RCT) and non-randomized controlled trials(NRCT) in English and Chinese literature and tracing to include literature references. Computer search:Pubmed、Ovid、EBSCO、EMBASE、C NKI、CBM; Google Scholar Manual searches:four Chinese journals 《Chinese Journal of Urology》、《Journal of Clinical Urology》、《Chinese Journal of Andrology》、《Journal of Andrology》。By two authors independently completed the literature search, screening, quality assessment,data extraction and fill in the form of data extraction,and cross-check-ing,and if have different views,discussion or judgment by a third party solution.The use RevMan5.0software to complete the relevant meta statistical analysis,and application fai-lsafe number and sensitivity analysis of the research literature of publication bias and r-eliability of the results of the analysis and evaluation,and finally the results of the analy sis finishing.Results:The final total of13included in the meta-analysis of literatures,a total of1018patients.Eight foreign language literatures,Five chinese literatures.Two RCT literatures, Eleven NRCT literatures.Baseline consistent with the literatures,the analysis showed:LNU and ONU was no statistically significant differences in operative time,p=0.49,weighted mean difference for8.98min,95%confidence interval(-16.73,34.70);LNU in intraoperative blood loss was less than the ONU,p<0.05,weighted mean difference is-57.98ml,95%c-onfidence interval(-82.00;-33.97);LNU is less than the ONU in the recovery time ofgast-rointestinal function,p<0.05,the weighted mean difference-19.9h,95%confidence interval (-27.38,-12.42);LNU is less than the ONU in the number of days in hospital, p<0.05, weighted mean difference-3.58d,95%confidence interval(-5.22,-1.93);LNU and ONU aft-er catheter indwelling time was no significant difference,p=0.96,weighted mean differe-nce0.12,95%confidence interval (-4.98,5.21);LNU and ONU in the bladder recurrence was no significant difference,p=0.47,OR is0.88,95%confidence interval(0.61,1.26);LN-U and ONU in the postoperative systemic transfer was no significant difference,p=1.53,OR is0.60,95%confidence interval(0.31,1.15);LNU no significant postoperative5-yea-rs survival differences in the ONU,p=0.75,OR is0.89,95%confidence interval(0.45,1.79).Conclusion:In the treatment of upper urinary tract urothelial cell carcinoma,LNU in in-traoperative blood loss,postoperative gastrointestinal function recovery, hospitalization tim-e was superior to the ONU,worthy of promotion; the operative time,indwelling catheter, bladder recurrence,systemic metastases,the5-years survival aspects of LNU and ONU w-as no significant difference. Because of the clinical RCT experimental literature less.Still need large, multi-center,prospective clinical RCT experiment further treatment of the upp er urinary tract urothelial cell carcinoma of the analysis of the comprehensive assessme-nt,in order to play a greater role in guiding the clinical.