Situmorang Gerhard Reinaldi, Irdam Gampo Alam, Abdullah Aaron
Department of Urology, University of Indonesia, Jakarta, Indonesia.
Urol Ann. 2022 Oct-Dec;14(4):359-364. doi: 10.4103/ua.ua_32_21. Epub 2022 Sep 16.
Bowel obstruction is a common complication that occurs in patient who underwent urinary diversion with an incidence of 0.7%-11%. Although previous studies have published risk factors, prevention and management of postoperative paralytic ileus, and data on urinary postdiversion bowel obstruction in the literature are still scarce and thus require further investigation of the diversion technique which allegedly has differences in pathogenesis, management, and results. To that end, this study conducted a systematic review study to compare two different diversion techniques, namely ileal conduit and continent diversion, especially orthotopic neobladder.
This study is a systematic review by searching study in online databases such as PubMed, EBSCOhost, and ProQuest. Inclusion criteria included are full-text articles, English language, and articles of the past 10 years. After searching, we analyzed quantitatively using the RevMan application for meta-analysis.
From 3403 studies, we got 12 studies that were included in the analysis. In a study conducted from the study of van Hemelrijck . stated that intestinal obstruction has an incidence of 50.73-1000, the third-highest when compared with advanced complications such as death (145.07/1000 population) and urinary tract infections (127.03/1000 population). It was found that odds ratio was 0.64 (0.45-0.91).
The ileal conduit and orthotopic neobladder methods have no significant difference in the incidence of intestinal obstruction.
肠梗阻是尿路改道患者中常见的并发症，发生率为0.7%-11%。尽管先前的研究已经公布了危险因素、术后麻痹性肠梗阻的预防和管理方法，但文献中关于尿路改道后肠梗阻的数据仍然稀少，因此需要进一步研究据称在发病机制、管理和结果方面存在差异的改道技术。为此，本研究进行了一项系统评价研究，以比较两种不同的改道技术，即回肠导管和可控性改道，特别是原位新膀胱。
本研究是一项系统评价，通过在PubMed、EBSCOhost和ProQuest等在线数据库中检索研究。纳入标准包括全文文章、英语语言以及过去10年的文章。检索后，我们使用RevMan应用程序进行定量分析以进行荟萃分析。
从3403项研究中，我们获得了12项纳入分析的研究。在van Hemelrijck等人进行的一项研究中指出，肠梗阻的发生率为50.73-1000，与死亡（145.07/1000人口）和尿路感染（127.03/1000人口）等晚期并发症相比，排名第三高。发现比值比为0.64（0.45-0.91）。
回肠导管和原位新膀胱方法在肠梗阻发生率方面没有显著差异。
