SynthesisFrontiers in oncology2026
Comparison of the efficacy of different orthotopic neobladder reconstruction techniques following radical cystectomy for bladder cancer: a network meta-analysis.
Synthesis in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
Background: Orthotopic neobladder (ONB) reconstruction is increasingly utilized following radical cystectomy (RC) for bladder cancer (BC). However, the comparative functional performance of different ONB techniques remains inconclusive. Materials and methods: A systematic review and network meta-analysis were conducted in accordance with the PRISMA-NMA guidelines. The study protocol was prospectively registered in PROSPERO (CRD420251143294). PubMed, EMBASE, and the Cochrane Library were systematically searched from database inception to October 2025. Eligible studies included those enrolled patients undergoing RC with any ONB technique and reported at least one predefined outcome: maximum neobladder capacity (MNC), maximal flow rate (MFR), postvoid residual volume (PVR), daytime continence (DC), or nighttime continence (NC). A Bayesian random-effects model was applied to synthesize direct and indirect evidence and to rank interventions using the surface under the cumulative ranking curve (SUCRA). Results: Fifteen studies involving 1,129 patients and 14 ONB reconstruction techniques were included. Most techniques showed no statistically significant differences compared with the Studer pouch across core functional outcomes. However, the Studer pouch demonstrated superior DC compared with the Camey I pouch, while the ileocecal pouch achieved significantly lower PVR than the Studer pouch (both P < 0.05). SUCRA-based rankings indicated that the T pouch, Xing pouch, Ileocecal pouch, Y pouch, and Mainz pouch performed best for MNC, MFR, PVR, DC, and NC, respectively. Conclusion: Across five core functional outcomes, most ONB reconstruction techniques demonstrated comparable performance. SUCRA-derived rankings may facilitate individualized selection of ONB reconstruction techniques in clinical practice. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251143294, identifier CRD420251143294.
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