Effect of ileal orthotopic neobladder and ileal conduit diversion on patient's quality of life after cystectomy: a Meta-analysis

Abstract

Objective To compare quality of life(QOL)in patients undergoing ileal orthotopic neobladder(IONB) or ileal conduit(IC)after radical cystectomy (RC), through a systematic review and Meta-analysis. Methods All relevant published studies about the comparison between IONB and IC using validated QOL questionnaires were searched, including CBM Disc, CNKI, VIP, Wanfang Data, Pubmed, Medline, Embase, The Cochrane Library, dated from January 2005 to April 2018. Results Twelve controlled studies and 1207 cases were included. Five validated scales were Specific Scale(FACT-BL, EORTC QLQ-C30, EORTC QLQ-BLM30, BCI), General Scale(SF-36). The Meta-analysis outcomes: IONB showed a signifcantly better QOL in patients versus IC (SMD=0.27, 95%CI=0.13-0.41, P=0.0002). Further comparison between dimension scores , pooled effects sizes of all FACT-BL aspects only a significant better PWE and FWB in patients with IONB. There were no significant differences in EWB, SWB and BSS. Also no significant differences in aspects of future perspective, abdominal bloating and flatulence, body image between IC and IONB groups using EORTC QLQ-BLM30. Analyzing BCI aspects, urinary function was significantly better in IC patients(P=0.003), no significant in urinary bother. Analyzing EORTC-QLQ-C30 aspects, only CF(P=0.03) was significantly better in patients with IONB. There was no significant in PF, RF, EF, SF and GQOL. Compared with all aspects of SF-36, there was only significant higher scores in PF(P=0.003) , IONB was superior to IC. Conclusions According to the not-random evidence, QOL after cystectomy undergoing IONB is superior than IC in some aspects. Key words: Cystectomy; Urinary Diversion; Quality of Life; Meta-Analysis