Systematic review and meta-analysis on laparoscopic cystectomy in bladder cancer

BACKGROUND: This study aimed to systematically evaluate the efficacy of laparoscopic radical cystectomy (LRC) surgical therapy in patients with bladder cancer (BC), and to provide evidence for the clinical treatment of BC. METHODS: The Embase, Ovid, PubMed, Medline, Springer, and Web of Sciences database were searched to screen articles with clinical controlled trials on LRC treatment of BC. The Cochrane Handbook 5.0.2 software and Review Manager 5.3 software were adopted to evaluate the risk of bias and to perform a meta-analysis of the included articles in this study. RESULTS: A total of 12 articles were obtained, including 1,283 research cases. The meta-analysis results showed that relative to the control group (Ctrl), the observation group (Observ group) had significantly lower intraoperative blood loss (IBL) after LRC [mean difference (MD) =−458.75; 95% confidential interval (CI): −505.75 to −411.76; Z=19.13; P<0.00001], blood transfusion rate (BTR) (odds ratio =0.36; 95% CI: 0.13–0.94; Z=2.08; and P=0.04), use of analgesics (MD =−24.53; 95% CI: −39.04 to −10.01; Z=3.31; and P=0.0009), and incidence of postoperative complications (Risk ratio =0.58; 95% CI: 0.39–0.85; Z=2.77; and P=0.006). However, and the length of hospital stay could not be shortened (MD =–2.43; 95% CI: –4.83 to –0.02; Z=1.98; and P=0.05). DISCUSSION: LRC treatment of BC could effectively reduce the amount of IBS, and lower the intraoperative BTR, use of analgesics, and incidence of postoperative complications. Therefore, it could be used in the clinical surgical treatment of BC patients.