Introduction: Pelvic lymph node dissection (PLND) is commonly performed during radical prostatectomy (RP) for prostate cancer staging. This study aimed to comprehensively analyze existing evidence compare perioperative complications associated with standard (sPLND) versus extended PLND templates (ePLND) in RP patients. Methods: A meta-analysis of prospective studies on PLND complications was conducted. Systematic searches were performed on Web of Science, Pubmed, Embase, and the Cochrane Library until May 2023. Risk ratios (RRs) were estimated using random-effects models in the meta-analysis. The statistical analysis of the data was carried out using Review Manager software. Results: Nine studies, including three randomized clinical trial and six prospective studies, with a total of 4962 patients were analyzed. The meta-analysis revealed that patients undergoing ePLND had a higher risk of partial perioperative complications, such as lymphedema (I ²=28%; RR 0.05; 95% CI: 0.01–0.27; P<0.001) and urinary retention (I ²=0%; RR 0.30; 95% CI: 0.09–0.94; P=0.04) compared to those undergoing sPLND. However, there were no significant difference was observed in pelvic hematoma (I ²=0%; RR 1.65; 95% CI: 0.44–6.17; P=0.46), thromboembolic (I ²=57%; RR 0.91; 95% CI: 0.35–2.38; P=0.85), ureteral injury (I ²=33%; RR 0.28; 95% CI: 0.05–1.52; P=0.14), intraoperative bowel injury (I ²=0%; RR 0.87; 95% CI: 0.14–5.27; P=0.88), and lymphocele (I ²=0%; RR 1.58; 95% CI: 0.54–4.60; P=0.40) between sPLND and ePLND. Additionally, no significant difference was observed in overall perioperative complications (I ²=85%; RR 0.68; 95% CI: 0.40–1.16; P=0.16). Furthermore, ePLND did not significantly reduce biochemical recurrence (I ²=68%; RR 0.59; 95% CI: 0.28–1.24; P=0.16) of prostate cancer. Conclusion: This analysis found no significant differences in overall perioperative complications or biochemical recurrence between sPLND and ePLND, but ePLND may offer enhanced diagnostic advantages by increasing the detection rate of lymph node metastasis.

Background: Ureteral stones are common disorders of the urinary system, and larger proximal stones (>10 mm) often require surgical intervention due to their difficulty in passing naturally. The optimal surgical approach remains a matter of debate. This study compares the efficacy and safety of ureteroscopic lithotripsy (URSL) and laparoscopic ureterolithotomy (LU) for large proximal ureteral stones to inform clinical decisions. Method: A systematic review was conducted, encompassing randomized controlled trials (RCTs) from PubMed, Embase, Web of Science, Cochrane Library, and ResearchGate. Result: For our primary outcomes, LU demonstrated a significant benefit over URSL in terms of overall success rate, stone-free rate (SFR), initial SFR, SFR at 3 weeks, SFR at 1 month, and SFR at discharge, reducing the need for auxiliary treatment, lowering the residual calculi rate. LU significantly reduced the incidence of various complications. Specifically, among patients treated with LU, the occurrence of Clavien–Dindo Grade 2 and 3 complications is lower. Additionally, the incidence of mucosal injury, stone retropulsion, ureteral perforation, ureteral stenosis, and urinary tract infection is also lower in patients treated with LU. According to our subgroup analysis, both transperitoneal laparoscopic ureterolithotomy (TLU) and retroperitoneal laparoscopic ureterolithotomy (RLU) improved SFR, reduced the need for auxiliary treatment and stone retropulsion compared to URSL. Conclusion: Compared with URSL, LU demonstrates a higher SFR and fewer complications for patients with proximal ureteral stones larger than 10 mm.

Background. In order to prevent the recurrence and progression of intermediate- and high-risk non-muscle invasive bladder cancer (NMIBC) after transurethral resection of bladder tumor (TURBT), various bladder instillation therapies have been developed in recent years. Among these, device-assisted Hyperthermic Intravesical Chemotherapy (HIVEC) has received a great deal of attention. Objective. To identify the efficacy and safety of HIVEC, we conducted this meta-analysis. Methods. We identified relevant articles from PubMed, Embase, and Cochrane Library databases. All published randomized controlled trials (RCTs) describing the role of bladder instillation for the treatment of intermediate- and high-risk NMIBC were involved. Outcomes included 1–3 years Recurrence-Free Survival (RFS), 1–3 years Progression-Free Survival (PFS), 5 years Overall Survival (OS), Adverse Events (AEs), and relevant subgroup analyses. Result. Our study involved a total of 10 RCTs and 1360 patients. In subgroup analysis, we found that compared to MMC instillation, HIVEC decreased the 1–3 years RFS (OR = 0.51; ) while not increasing the incidence of AEs (OR = 0.86; ). Compared with BCG instillation, HIVEC reduced the incidence of serious AEs (OR = 0.21; ) while bringing the same efficacy (OR = 0.78; ). Conclusion. HIVEC combined the advantages of efficacy and safety compared with the two recommended instillation modalities. As a potential alternative therapy, its widespread clinical effect remains to be further evaluated.