#0215

META-ANALYTICAL ASSESSMENT ABOUT STANDARD AND EXTENDED PELVIC LYMPH NODE DISSECTION IN TERMS OF POST-OPERATIVE COMPLICATIONS IN PATIENTS UNDER RADICAL CYSTECTOMY

R. Utanes¹, J. Agatep¹

¹East Avenue Medical Center, Urology, Quezon City, Philippines

Introduction:

Radical cystectomy (RC) with pelvic lymph node dissection (PLND) is regarded to be the standard mode of care for bladder cancer. It is a major surgical procedure that has associated serious complications which generally develop in the early perioperative stage. Studies have focused on the prognostic value of anatomic template and/or lymph node count. Interestingly, the therapeutic value of pelvic lymph node dissection at radical cystectomy over cystectomy alone has never been assessed through randomized approach. However, two population based investigations have been made about the over-all long term overall survival for patients with or without radical cystectomy to which data indicate that pelvic lymph node dissection could lead to 7 to 11% over-all survival rate that is significantly higher in radical cystectomy without pelvic lymph node dissection.To conduct a meta-analytical assessment comparing extended pelvic lymph node dissection to standard pelvic lymph node dissection in terms of perioperative complications in patients who had radical cystectomy

Material and methods:

The researcher conducted a meta-analysis. Therefore, specific parameters were covered in the studies included. In the study, complications were recorded in both approaches specifically standard and extended pelvic lymph node dissection. Complications assessed were blood loss, blood transfusion, lymphocele, incision hernia, anastomosis leak, and length of stay, and Clavien Dindo of patients. After data were collected, these were encoded in Review Manager (RevMan) version 5.0 where risk bias assessment and statistical analyses were done.

Results:

Higher incidence of blood transfusion (874 cc; p .000 < .05), incision hernia (n=22; p .050 = .05), and longer hospital stay (14 days; p .050 = .05) were noted in the sPLND group. On the other hand, a higher mean blood transfusion (n=55; p .001 < .05), lymphocele (n=16; p .270 > .05), and anastomosis leak (n=9; p .760 > .05) were specifically observed in the ePLND group. Most of the Clavien Dindo 2 (n=125; p .060 > ;05), 3 (n=125; p .150 > .05), and 4 (n=16; p .770 > .05) patients were in the sLND group.