Meta-analysis Of Comparison Of Perioperative Outcomes And Complications Between Intracorporeal And Extracorporeal Orthotopic Ideal Neobladder After Laparoscopic Or Robot-assisted Radical Cystectomy

Objective: Using medical data analysis method by Searching and collecting relevant medical literature,Contrast of perioperative outcomes between intracorporeal and extracorporeal orthotopic ideal neobladder after laparoscopic or robot-assisted radical cystectomy,to provide evidence support for clinical work.Methods: Using computer to comprehensively search electronicbiological databases such as Pub Med,Em Base,Web of Science,CNKI,CMCI,and Wanfang Database.From January 01,2010 to Dece-mber 31,2020 published reports containing contrast of perioperativ-e outcomes between intracorporeal and extracorporeal orthotopic ide-al neobladder after laparoscopic or robot-assisted radical cystectomy,The selected literatures were included and excluded according to therequirements.Finally,Rev-Man5.4software provided by Cochrane C-ollaboration was used for Meta-analysis according to the data type.Results: In this study,a total of 7 literatures were screened out that met the requirements,including 6 English literatures and 1 Chinese literature.A total of 1016 patients were enrolled,all of them underwent laparoscopic or robot-assisted radical cystectomy,all use ileum as the material for the orthotopic neobladder in the proce-ss of urinary diversion.The details of this study were as follows: 531 patients underwent extracorporeal orthotopic ideal neobladder(ECIN)and 485 patients underwent Intracorporeal orthotopic ideal neo-bladder(ICIN).The final result shows that: ICIN group in surgical blood loss(WMD: 73.65,95% CI 16.08-131.22,P < 0.05),postop-erative intestinal function recovery time(WMD: 1.50,95% CI 0.99-2.01,P < 0.05),the incidence of postoperative complications(OR:1.91,95% CI 1.44-2.54,P<0.05)were better than ECIN group,but in the operation time(WMD:-6.48,95%CI-22.48-9.52,P>0.05)and postoperative hospital stay time(WMD:0.91,95%CI-1.12-2.95,P>0.05)were not significantly different from ECIN group.Conclusion: The data of this study shows that ICIN is better than ECIN in terms of surgical blood loss,postoperative intestinal function recovery time and the incidence of postoperative complications.ICIN is similar to ECIN in terms of the operation time and postoperative hospital stay time.For patients with muscular invasive bladder cancer(MIBC)or high-risk non-muscular invasive bladder cancer(NMIBC),ICIN is the best choice of urinary diversion.