Ileal conduit vs. orthotopic ileal neobladder after radical cystectomy: Systematic review and meta-analysis of long-term renal function.
Tarek Mohamed, Hamza Mohamed, Mohammad Ghassab Deameh et al.
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In 30 seconds
This systematic review and meta-analysis evaluated long-term renal function outcomes in adults undergoing radical cystectomy with either ileal conduit (IC) or orthotopic neobladder (NB) for bladder cancer. The analysis of 14 studies found no significant differences in mean change in eGFR (-2.48 mL/min/1.73 m², P = 0.28) or incidence of end-stage renal disease (RR 0.63, P = 0.33) between the two groups.
Key findings
- Mean change in eGFR was -2.48 mL/min/1.73 m² for NB vs. IC (P = 0.28).
- Incidence of ESRD was comparable: RR 0.63 for NB vs. IC (P = 0.33).
- Neobladder was associated with a higher risk of uretero-intestinal stricture (RR 2.58, P = 0.01).
- Neobladder creation required a longer operative time, averaging 80.11 minutes more (P < 0.00001).
Why it matters
Understanding the long-term renal outcomes associated with different urinary diversion techniques is crucial for clinicians to make informed decisions tailored to individual patient needs and comorbidities, particularly in the context of bladder cancer treatment.
What to keep in mind
The study acknowledges limitations including the small number of included studies, heterogeneity, and potential selection bias.