Laparoscopic versus open nephroureterectomy for upper urinary tract urothelial carcinoma: A systematic review and meta-analysis. Issue 35 (August 2018) - Liu, Feng
Abstract: Purpose: To evaluate the efficacy and safety of laparoscopic nephroureterectomy (LNU) and open nephroureterectomy (ONU) for the treatment of upper urinary tract urothelial carcinoma (UTUC). Methods: PubMed, Embase, and Cochrane databases were selected for systematic review of trials that compared outcomes of LNU and ONU. Meta-analysis was performed using RevMan 5.3 and STATA 13.0 software. Results: LNU was associated with longer operation time ( P < .001), shorter hospital stay ( P < .001), less blood loss ( P = .006) and lower rate of transfusion ( P < .001). The occurrence of complications, including minor ( P = .52), major ( P = .21) and total complications ( P = .19) were similar between LNU and ONU. There was no significant difference in the rate of 5-year recurrence-free survival ( P = .90), 5-year cancer-specific survival ( P = .12), and 5-year overall survival ( P = .11) as well as 2-year RFS ( P = .84), 2-year CSS ( P = .86), and 2-year OS ( P = .25). Conclusion: Our results indicated that LNU is a safe and effective method to treat UTUC. Given the limitations of this study, further multicenter, randomized trials are required to confirm these findings.