Divisão de Urologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil.
Hospital Municipal da Vila Santa Catarina, São Paulo, SP, Brasil.
Int Braz J Urol. 2022 Jan-Feb;48(1):18-30. doi: 10.1590/S1677-5538.IBJU.2020.0892.
A systematic review of the literature with available published literature to compare ileal conduit (IC) and cutaneous ureterostomy (CU) urinary diversions (UD) in terms of perioperative, functional, and oncological outcomes of high-risk elderly patients treated with radical cystectomy (RC). Protocol Registration: PROSPERO ID CRD42020168851.
A systematic review, according to the PRISMA Statement, was performed. Search through the Medline, Embase, Scopus, Scielo, Lilacs, and Cochrane Database until July 2020.
The literature search yielded 2,883 citations and were selected eight studies, including 1096 patients. A total of 707 patients underwent IC and 389 CU. Surgical procedures and outcomes, complications, mortality, and quality of life were analyzed.
CU seems to be a safe alternative for the elderly and more frail patients. It is associated with faster surgery, less blood loss, lower transfusion rates, a lower necessity of intensive care, and shorter hospital stay. According to most studies, complications are less frequent after CU, even though mortality rates are similar. Studies with long-term follow up are awaited.
对现有文献进行系统回顾，以比较在根治性膀胱切除术（RC）治疗的高危老年患者中，回肠造口术（IC）和皮输尿管造口术（CU）在围手术期、功能和肿瘤学结局方面的差异。文献注册：PROSPERO 注册号 CRD42020168851。
根据 PRISMA 声明进行了系统回顾。检索了 Medline、Embase、Scopus、Scielo、Lilacs 和 Cochrane 数据库，检索时间截至 2020 年 7 月。
文献检索得到 2883 条引文，选择了 8 项研究，共纳入 1096 例患者。共有 707 例患者接受了 IC 手术，389 例患者接受了 CU 手术。分析了手术程序和结果、并发症、死亡率和生活质量。
CU 似乎是老年和身体更虚弱患者的安全替代方法。它与手术更快、失血量更少、输血率更低、对重症监护的需求更低以及住院时间更短相关。根据大多数研究，CU 术后并发症较少，尽管死亡率相似。需要进行长期随访的研究。
