A comparison between limited bowel preparation and comprehensive bowel preparation in radical cystectomy with ileal urin
- PDF / 2,593,988 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 82 Downloads / 162 Views
UROLOGY - REVIEW
A comparison between limited bowel preparation and comprehensive bowel preparation in radical cystectomy with ileal urinary diversion: a systematic review and meta‑analysis of randomized controlled trials Dechao Feng1 · Xue Li2 · Shengzhuo Liu1 · Ping Han1 · Wuran Wei1 Received: 8 March 2020 / Accepted: 19 May 2020 / Published online: 24 September 2020 © Springer Nature B.V. 2020
Abstract Purpose Our aim is to evaluate the value of limited bowel preparation (LBP) in radical cystectomy (RC) with ileal urinary diversion (IUD). Methods A systematic literature search was conducted on electronic database up to February 2020. All data were analyzed using RevMan5 (version 5.3). A subgroup analysis comparing the efficacy of CBP and no bowel preparation (NBP) was also performed. Results Six randomized controlled trials (RCTs) including 743 patients were finally enrolled for statistical analysis. According to the meta-analysis, there was no significant difference between LBP group and comprehensive bowel preparation (CBP) group, concerning operative time (p = 0.79), length of stay (p = 0.46), the time to first toleration of clear liquids (p = 0.95), and overall complications (p = 0.29). However, the time to first bowel activity (SMD: − 0.77, 95% CI − 1.47 to − 0.07, p = 0.03), risk of fever (RR: 0.53, 95% CI 0.33–0.85, p = 0.008), time to first flatus (SMD: − 1.06, 95% CI − 2.02 to − 0.10, p = 0.03), and risk of wound healing disorders (RR: 0.65, 95% CI 0.44–0.95, p = 0.03) were significantly lower in LBP group compared with CBP group. Subgroup analysis showed a significant lower risk of wound healing disorders in favor of NBP (RR: 0.50, 95% CI 0.29–0.87, p = 0.01). Conclusions Current evidence indicated that LBP protocols might accelerate recovery of gastrointestinal function, promote wound healing, and reduce the risk of fever without increasing complications in patients undergoing RC with IUD. Besides, bowel preparation also did not hinder wound healing. Further, well-designed RCTs conducted by experienced surgeons are warranted before making the final clinical guidelines. Keywords Bowel preparation · Radical cystectomy · Ileal urinary diversion · Meta-analysis · Randomized controlled trials
Introduction
Dechao Feng and Xue Li contributed equally to this work and should be considered as co-first author. * Wuran Wei [email protected] 1
Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Guoxue Xiang #37, Chengdu 610041, People’s Republic of China
Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, People’s Republic of China
2
Bowel preparation (BP) is an integral part of perioperative patient care protocol for those who have a scheduled abdominal surgery. Comprehensive bowel preparation (CBP) has been representing the standard of BP protocol for many years. As is required in most CBP protocols, patients usually underwent a series of regimens that consist of oraladministered bisacodyl, oral-administered
Data Loading...
