| Background: Bladder cancer is one of the most common malignant tumors in the urinary system,which seriously threatens human life and health.With the aging of China's population increasing,the incidence of bladder cancer is on the rise,and the muscle-invasive bladder cancer which is easy to progress and shift accounts for about 20% ? 25% in all kinds of the bladder cancer.Bladder radical resection combined with urinary diversion is the most effective method for the treatment of muscle-invasive bladder cancer and high-risk non-muscle-invasive bladder cancer,which can maximize the patient's life cycle and improve the prognosis of patients.The choice of permanent urinary diversion that can not only protect the upper urinary tract function but also improve the postoperative quality of life of patients is the primary problem after complete bladder resection.At present,the commonly used methods of urinary diversion include ileal neobladder(IN),ileal conduit(IC)and ureterocutaneostomy(CU).These three kinds of operations have their own advantages and cannot be replaced by each other.Previous discussions on urinary diversion focused on surgical indications,surgical methods and complications,but few studies on postoperative health-related quality of life in patients with bladder cancer.A meta-analysis method is proposed to evaluate the quality of life of Chinese patients with bladder cancer after different urinary flow diversion.Objective: By comparing the quality of life of Chinese patients with bladder cancer after receiving different urinary diversion methods,this paper provides a supportive reference for the selection of urinary diversion methods after bladder resection.Methods: Retrieved from CNKI,CQVIP,CBM and Wanfang database during from January 2010 to January 2020,prospective,retrospective and cross-sectional studies on the different ways of urinary diversion after radical cystectomy.The Chinese keywords are "the bladder cancer","the radical resection of bladder”,”the urinary diersion" and "the quality of life".And established the inclusion and exclusion criteria,then searched literature,objectively evaluated the risk of bias,extracted the data in the final included literature,and used Stata15.1 software to perform the Meta analysis.Results: IN this study,a total of 18 literatures were selected on the comparison of life quality afterradical cystectomy IN different urinary flow diversion procedures,and a total of 1571 patients were included.According to different postoperative urinary flow diversion methods,they were divided into CU,IC and IN groups,among which 321 were IN the CU group,532 were IN the IC group,and 718 were IN the IN group.The results of Meta analysis showed that compared with IN group,IC group(SMD=-0.633,95%ci =-0.766?-0.500,P < 0.01),CU group compared with IN group(SMD=-0.484,95%ci=-0.652?-0.316,P < 0.01),IN group has higher quality of life after surgery.Compared with the IC group(SMD=-0.174,95%ci =-0.338?-0.010,P=0.396),there was no significant difference in postoperative quality of life between the CU group and the IC group.Conclusions: Among the three common ways of urinary diversion after radical cystectomy,orthotopic ileocesthrectomy is more beneficial to improve the postoperative quality of life. |
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