文章：

无症状回肠原位新膀胱患者的尿动力学参数与控尿效果：系统综述与荟萃分析

Urodynamic Parameters and Continence Outcomes in Asymptomatic Patients with Ileal Orthotopic Neobladder: A Systematic Review and Metanalysis

原文发布日期：22 March 2024

DOI: 10.3390/cancers16071253

类型: Article

开放获取: 是

英文摘要：

Introduction: The orthotopic neobladder is the type of urinary diversion (UD) that most closely resembles the original bladder. However, in the literature the urodynamic aspects are scarcely analysed. Objective: To provide the first systematic review (SR) on the urodynamic (UDS) outcomes of the ileal orthotopic neobladders (ONB). Continence outcomes are also presented. Methods: A PubMed, Embase and Cochrane CENTRAL search for peer-reviewed studies on ONB published between January 2001–December 2022 was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Results and Conclusion: Fifty-nine manuscripts were eligible for inclusion in this SR. A great heterogeneity of data was encountered. Concerning UDS parameters, the pooled mean was 406.2 mL (95% CI: 378.9–433.4 mL) for maximal (entero)cystometric capacity (MCC) and 21.4 cmH2O (95% CI: 17.5–25.4 cmH2O) for Pressure ONB at MCC. Postvoid-residual ranged between 4.9 and 101.6 mL. The 12-mo rates of day and night-time continence were 84.2% (95% CI: 78.7–89.1%) and 61.7% (95% CI: 51.9–71.1%), respectively.Despite data heterogeneity, the ileal ONB seems to guarantee UDS parameters that resemble those of the native bladder. Although acceptable rates of daytime continence are reported the issue of high rates of night-time incontinence remains unsolved. Adequately designed prospective trials adopting standardised postoperative care, terminology and methods of outcome evaluation as well as of conduction of the UDS in the setting of ONB are necessary to obtain homogeneous follow-up data and to establish UDS guidelines for this setting.

摘要翻译： 

引言：原位新膀胱是最接近原始膀胱的尿流改道方式。然而，文献中对其尿动力学特征的探讨较为有限。目的：针对回肠原位新膀胱的尿动力学结果进行首次系统性综述，并同时报告其控尿功能结果。方法：依据系统综述与荟萃分析优先报告条目声明，在PubMed、Embase及Cochrane CENTRAL数据库中检索2001年1月至2022年12月期间发表的关于原位新膀胱的同行评议研究。结果与结论：本综述共纳入59篇文献。数据显示存在较大异质性。尿动力学参数方面，最大（肠道）膀胱测压容量合并均值为406.2 mL（95%置信区间：378.9–433.4 mL），最大容量时新膀胱压力合并均值为21.4 cmH2O（95%置信区间：17.5–25.4 cmH2O）。排尿后残余尿量范围为4.9至101.6 mL。术后12个月日间与夜间控尿率分别为84.2%（95%置信区间：78.7–89.1%）和61.7%（95%置信区间：51.9–71.1%）。尽管存在数据异质性，回肠原位新膀胱的尿动力学参数仍显示出接近天然膀胱的特性。虽然日间控尿率可接受，但夜间尿失禁高发问题尚未解决。未来需通过精心设计的前瞻性试验，采用标准化的术后护理方案、规范化的术语体系、统一的结果评估方法及新膀胱尿动力学检测标准，以获取具有同质性的随访数据，并建立适用于该领域的尿动力学指南。

原文链接：

Urodynamic Parameters and Continence Outcomes in Asymptomatic Patients with Ileal Orthotopic Neobladder: A Systematic Review and Metanalysis