Evidence map›Paper›PMID 40130639›Full record

SynthesisBJU international2025

Indocyanine-guided ureter resection for radical cystectomy - a systematic review and meta-analysis.

Caelán Max Haney, Alexander Studier-Fischer, Mark Enrik Geissler, Jakob Ohlmeier, Niklas Westhoff, Jens-Uw Stolzenburg, Maurice Stephan Michel, Karl-Friedrich Kowalewski

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BJU international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Caelán Max HaneyIntelligent Systems and Robotics in Urology, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID https://orcid.org/0000-0002-4209-9470
Alexander Studier-FischerIntelligent Systems and Robotics in Urology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Mark Enrik GeisslerDepartment of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany.
Jakob OhlmeierDepartment of Urology and Urosurgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.
Niklas WesthoffDepartment of Urology and Urosurgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.
Jens-Uw StolzenburgDepartment of Urology, University of Leipzig, Leipzig, Germany.
Maurice Stephan MichelDepartment of Urology and Urosurgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.
Karl-Friedrich KowalewskiIntelligent Systems and Robotics in Urology, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID https://orcid.org/0000-0003-2931-6247

Funding

State Parliament of Baden-Württemberg for the Innovation Campus Health + Life Science Alliance Heidelberg Mannheim
6 · The paper itself

Abstract

objectivesTo perform a systematic review and meta-analysis of studies comparing indocyanine green (ICG)-guided resection of ureters with the standard of care during radical cystectomy (RC).

methodsThe Cochrane Central Register of Controlled Trials (CENTRAL), Medical Literature Analysis and Retrieval System Online (MEDLINE) and Web of Science were searched for studies comparing ICG-guided resection of ureters with the standard of care during RC. The primary outcome was the rate of uretero-intestinal stenosis (UIS) per patient, secondary outcomes included the rate of UIS per ureter, major and minor complications; re-interventions due to UIS, re-admissions and the length of ureter resected. Data were pooled as odds ratio (OR) or mean difference with a random-effects model. Risk of bias was assessed using the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) tool and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to assess certainty of evidence. The systematic review was registered prospectively via the International Prospective Register of Systematic Reviews (PROSPERO: CRD42024545516).

resultsIn all, 11 studies totalling 1339 patients were identified. ICG-guided resection led to a statistically significant decrease in UIS per patient (OR 0.20, 95% confidence interval [CI] 0.07-0.52) and per ureter (OR 0.17, 95% CI 0.06-0.50). There were statistically significantly fewer major complications, re-interventions due to UIS in the ICG-guided group, there was no difference in minor complications and re-admissions. Certainty of evidence was low.

conclusionsWith low certainty of evidence, ICG-guided resection of ureters lowers the rate of UIS. A standardisation of grading of UIS is needed. The time for randomised controlled trials in this setting is now.

Indexed as

Coloring AgentsCystectomyIndocyanine GreenSurgery, Computer-AssistedUreterUrinary Bladder NeoplasmsHumansColoring AgentsIndocyanine Greenbladder cancerfluorescence imagingindocyanine greenradical cystectomyureteric obstruction

Identifiers

PMID40130639
PMCPMC12053116

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.