Department of Urology, Tengzhou Central People's Hospital, Tengzhou, 277500, China.
Department of Traditional Chinese Medicine, The Sixth Medical Center of PLA General Hospital, Beijing, China.
Updates Surg. 2023 Oct;75(7):1795-1806. doi: 10.1007/s13304-023-01525-4. Epub 2023 May 15.
The prognosis and safety of continuous saline bladder irrigation (CSBI) after transurethral resection of bladder tumor (TURB) as an alternative method needs to be explored. A literature review and meta-analysis were performed by searching PubMed, EMBASE, Cochrane Library databases and original references of the included articles. PRISMA checklists were followed. We used the GRADEpro GDT to assess the certainty of evidence from the results of our meta-analysis. A total of eight articles including 1600 patients were studied. The results indicated that patients received CSBI after TURB had no statistical differences compared to the control group in the recurrence-free survival and progression-free survival. However, the CSBI group showed significant improvements compared to the control group in terms of the number of recurrences during follow-up and the period to first recurrence except for the number of tumor progression during follow-up. Furthermore, patients treated with CSBI did not show an inferior effect than those treated with immediate intravesical chemotherapy (IC) in respects of recurrence-free survival, progression-free survival, the number of recurrences during follow-up, the number of tumor progression during follow-up and the period to first recurrence. But the immediate IC group had a higher incidence than the CSBI group in terms of macrohematuria, micturition pain, frequency of urination, dysuria, retention and local toxicities. Patients treated with CSBI after TURB showed a significant improvement compared to the control group in terms of the number of recurrences during follow-up and the period to first recurrence. However, compared to immediate IC, CSBI did not show an inferior effect except for lower incidence of adverse reactions.PROSPERO registration number CRD42021247088.
经尿道膀胱肿瘤切除术（TURB）后持续生理盐水膀胱冲洗（CSBI）作为替代方法的预后和安全性需要探索。通过检索 PubMed、EMBASE、Cochrane 图书馆数据库和纳入文献的原始参考文献，进行了文献复习和荟萃分析。遵循 PRISMA 清单。我们使用 GRADEpro GDT 评估荟萃分析结果的证据确定性。共纳入 8 篇文章，包括 1600 例患者。结果表明，与对照组相比，接受 TURB 后 CSBI 的患者在无复发生存和无进展生存方面无统计学差异。然而，与对照组相比，CSBI 组在随访期间的复发次数和首次复发时间方面有显著改善，除了随访期间肿瘤进展的次数。此外，接受 CSBI 治疗的患者在无复发生存、无进展生存、随访期间的复发次数、随访期间肿瘤进展的次数和首次复发时间方面，与接受即刻膀胱内化疗（IC）治疗的患者相比，效果并不差。但是，即刻 IC 组的血尿、尿痛、尿频、排尿困难、尿潴留和局部毒性的发生率高于 CSBI 组。与对照组相比，TURB 后接受 CSBI 治疗的患者在随访期间的复发次数和首次复发时间方面有显著改善。然而，与即刻 IC 相比，CSBI 除了不良反应发生率较低外，效果并不差。PROSPERO 注册号 CRD42021247088。
