Quality of Life and Postoperative Complications of Single- or Bilateral-Stoma Cutaneous Ureterostomy Compared to Ileal Conduit After Radical Cystectomy: A Systematic Review and Meta-Analysis.

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology Pub Date : 2025-09-25 DOI:10.1016/j.urology.2025.09.034

Marvel Pratama Tjiaman, Muhammad Zen Zaidan, Zidan Fawwaz Ausath, Aurellie Tabitha Putri, Anneta Sanjaya Tjiaman, Armand Achmadsyah, Ervita Mediana, Agus Rizal Ardy Hariandy Hamid

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Abstract

Objective: To compare postoperative complications and quality of life among patients undergoing ileal conduit (IC), single-stoma cutaneous ureterostomy (SSCU), and bilateral-stoma cutaneous ureterostomy (BSCU) following radical cystectomy for muscle-invasive bladder cancer (MIBC). Method This systematic review and meta-analysis followed the Cochrane Handbook for Systematic Reviews of Interventions 6.2 and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. A comprehensive literature search was performed on PubMed, Cochrane, Wiley, and Scopus starting from 11 April 2025.

Result: Eleven studies met the inclusion criteria. IC showed significantly better physical QoL based on FACT scores (SMD: 0.63; 95% CI: 0.02-1.24; p = 0.04), particularly compared to BSCU (MD: 18.43; p < 0.0001), with no significant difference versus SSCU. However, IC had a higher risk of wound infection (OR: 3.02; p = 0.004) and early pyelonephritis (OR: 3.04; p = 0.02), especially when compared to SSCU. No significant differences were observed in ileus or wound dehiscence.

Conclusion: IC may offer better physical QoL, particularly over BSCU. However, SSCU offers similar QoL with lower rates of infection and pyelonephritis.

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与根治性膀胱切除术后的回肠导管相比，单口或双口皮肤输尿管造口术的生活质量和术后并发症：一项系统回顾和荟萃分析。

目的：比较肌肉浸润性膀胱癌（MIBC）根治性膀胱切除术后行回肠导管（IC）、单口皮肤输尿管造口（SSCU）和双口皮肤输尿管造口（BSCU）患者的术后并发症和生活质量。方法采用Cochrane干预措施系统评价手册6.2和系统评价和荟萃分析首选报告项目（PRISMA）清单进行系统评价和荟萃分析。从2025年4月11日起，在PubMed、Cochrane、Wiley和Scopus上进行了全面的文献检索。结果：11项研究符合纳入标准。基于FACT评分，IC表现出明显更好的物理生活质量（SMD: 0.63; 95% CI: 0.02-1.24; p = 0.04），特别是与BSCU （MD: 18.43; p < 0.0001）相比，与SSCU没有显著差异。然而，与SSCU相比，IC有更高的伤口感染（OR: 3.02; p = 0.004）和早期肾盂肾炎（OR: 3.04; p = 0.02）的风险，尤其是与SSCU相比。在肠梗阻或伤口裂开方面，两组无显著差异。结论：IC可以提供更好的物理生活质量，特别是与BSCU相比。然而，SSCU提供类似的生活质量，感染和肾盂肾炎的发生率较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urology 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

9.50%

发文量

716

审稿时长

59 days

期刊介绍： Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.