A Systematic Review and Meta-analysis on Perioperative Stenting/Dwell Time and Postoperative Outcomes in Patients Undergoing Radical Cystectomy and Urinary Diversion for Bladder Cancer
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVE: Ureteral stents are used to protect the ureteroenteric anastomosis during radical cystectomy and urinary diversion (RCUD); however, complications can occur from its use. The objective of this study was to perform a systematic review of perioperative stenting strategies and postoperative outcomes in patients undergoing RCUD for bladder cancer. METHODS: This review was published via PROSPERO (CRD42024558468) and conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Medline, Medline In-Process, Embase, and the Cochrane Central Register of Controlled Trials were searched. Prospective comparative (randomised and nonrandomised) studies published until June 2024 were included. All outcomes were included in the analysis. Risk of bias assessments were undertaken. KEY FINDINGS AND LIMITATIONS: The search yielded 1516 abstracts. Six prospective comparative studies (740 patients) were included. Although there was some evidence of reduced postoperative complications (urinary leak, ureteroileal stricture, postoperative obstruction, length of stay, and readmission within 30 d) with the omission of stents during RCUD, this did not reach statistical significance (n = 3). No differences in postoperative complications were identified between internal and external stenting (n = 2). Early stent removal (5 d) was associated with reduced urinary tract infections and hospital readmission (n = 1). There was a high/serious risk of bias with all studies. CONCLUSIONS AND CLINICAL IMPLICATIONS: The role of perioperative stenting during RCUD in preventing ureteroenteric complications remains equivocal and does not favour one approach over another. Until further results from on-going randomised controlled trials become available, urologists should carefully consider the indications to place a ureteric stent and its retention time after RCUD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.039 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.036 |
| Bibliometrics | 0.006 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".