Meta-analysis Of Laparoscopic And Open Radical Cystectomy In The Treatment Of Bladder Cancer

Objective:This aim of study was to conduct a meta-analysis to assess the overall efficacy and safety of laparoscopic radical cystectomy (LRC) vs open radical cystectomy (ORC) for patients with bladder cancer.Methods:All published randomized controlled trials and clinical controlled trials was selected from electronic databases Pubmed/Medline, The Cochrane Central Register of Controlled Trials (The Cochrane Library),Wanfang, ScienceDirect, Scopus and CNKI from January 1,1990 to March 30,2015. These articles must evaluate the efficacy and safety of LRC vs ORC in the treatment of bladder cancer and meet the inclusion and exclusion cirteria. We performed a Meta-analysis uising Review Manager software (version 5.3) after assessing the quality of included studies and extracted data.Results:A total of twelve trials were identified form electronic databases, which involving four English language literatures and eight Chinese literatures met the cirteria. LRC was associated with spending more operative time (WND: 42.38,95% CI:27.51～57.26, P<0.05) comparing with ORC. But patients can benefit from significantly less blood loss (WND:-395.28,95%CI:-544.58～-245.99,P<0.05), shorter time to recovery of intestinal function (WND:-1.71,95%CI:-2.23～-1.19,P<0.05) and hospital stay (WND:-4.15,95%CI:-5.48～-2.82, P<0.05), fewer overall complications (OR:0.47,95% CI:0.33～ 0.67, P<0.05) in LRC group. There was not significant different in positive surgical margins (OR:0.58,95% CI:0.14～2.35, P>0.05) and dissecting lymph nodes (WND:0.98,95%CI:-2.62～4.57, P>0.05) between LRC and ORC.Conclusion:We suggest that LRC may be a better method than ORC except the operative time from the current data.But further large-scale, well-designed,multi-center,long term follow-up studies shoulder be undertaken in treatment of bladder cancer between LRC and ORC.