Systematic review comparing uretero-enteric stricture rates between open cystectomy with ileal conduit, robotic cystectomy with extra-corporeal ileal conduit and robotic cystectomy with intra corporeal ileal conduit formation

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Udgivet i:Journal of Robotic Surgery vol. 18, no. 1 (Dec 2024), p. 100
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Springer Nature B.V.
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022 |a 1863-2483 
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024 7 |a 10.1007/s11701-024-01850-9  |2 doi 
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245 1 |a Systematic review comparing uretero-enteric stricture rates between open cystectomy with ileal conduit, robotic cystectomy with extra-corporeal ileal conduit and robotic cystectomy with intra corporeal ileal conduit formation 
260 |b Springer Nature B.V.  |c Dec 2024 
513 |a Evidence Based Healthcare Journal Article 
520 3 |a Cystectomy is the gold standard treatment for muscle invasive bladder cancer. Robotic cystectomy has become increasingly popular owing to quicker post- operative recovery, less blood loss and less post-operative pain. Urinary diversion is increasingly being performed with an intracorporeal technique. Uretero-enteric strictures (UES) cause significant morbidity for patients. UES for open cystectomy is 3–10%, but the range is much wider (0–25%) for robotic surgery. We aim to perform systematic review for studies comparing all 3 techniques, to assess for ureteric stricture rates. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement (Page et al. in BMJ 29, 2021). PubMed, Scopus and Embase databases were searched for the period January 2003 to June 2023 inclusive for relevant publications.The primary outcome was to identify ureteric stricture rates for studies comparing open cystectomy and urinary diversion, robotic cystectomy with extracorporeal urinary diversion (ECUD) and robotic cystectomy with intracorporeal urinary diversion (ICUD). Three studies were identified and included 2185 patients in total. The open operation had the lowest stricture rate (9.6%), compared to ECUD (12.4%) and ICUD (15%). ICUD had the longest time to stricture (7.55 months), ECUD (4.85 months) and the open operation (4.75 months). Open operation had the shortest operating time. The Bricker anastomoses was the most popular technique. Open surgery has the lowest rates of UES compared to both robotic operations. There is a learning curve involved with performing robotic cystectomy and urinary diversion, this may need to be considered to decide whether the technique is comparable with open cystectomy UES rates. Further research, including Randomised Control Trials (RCT), needs to be undertaken to determine the best surgical option for patients to minimise risks of UES. 
653 |a Urine 
653 |a Patients 
653 |a Surgical techniques 
653 |a Learning curves 
653 |a Surgeons 
653 |a Bladder 
653 |a Robotic surgery 
653 |a Urological surgery 
653 |a Intervention 
653 |a Systematic review 
653 |a Bladder cancer 
773 0 |t Journal of Robotic Surgery  |g vol. 18, no. 1 (Dec 2024), p. 100 
786 0 |d ProQuest  |t Health & Medical Collection 
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