Lingual versus buccal mucosal graft for augmentation urethroplasty: a meta-analysis of surgical outcomes and patient-reported donor site morbidity.

Autor: Wang A; Department of Urology, Eastern Virginia Medical School, Devine-Jordan Center for Reconstructive Surgery and Pelvic Health Urology of Virginia, 225 Clearfield Avenue, Virginia Beach, Norfolk, VA, 23462, USA., Chua M; Department of Urology, Eastern Virginia Medical School, Devine-Jordan Center for Reconstructive Surgery and Pelvic Health Urology of Virginia, 225 Clearfield Avenue, Virginia Beach, Norfolk, VA, 23462, USA.; Division of Urology, Hospital for Sick Children, University of Toronto, Toronto, Canada.; Institute of Urology, St. Luke's Medical Center, Quezon City, Philippines., Talla V; Old Dominion University, Norfolk, VA, USA., Fernandez N; Division of Urology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA., Ming J; Department of Surgery, Urology Division, University of New Mexico, Albuquerque, NM, USA., Sarino EM; Reference Services, Brickell Medical Science Library, Eastern Virginia Medical School, Norfolk, VA, USA., DeLong J; Department of Urology, Eastern Virginia Medical School, Devine-Jordan Center for Reconstructive Surgery and Pelvic Health Urology of Virginia, 225 Clearfield Avenue, Virginia Beach, Norfolk, VA, 23462, USA., Virasoro R; Department of Urology, Eastern Virginia Medical School, Devine-Jordan Center for Reconstructive Surgery and Pelvic Health Urology of Virginia, 225 Clearfield Avenue, Virginia Beach, Norfolk, VA, 23462, USA., Tonkin J; Department of Urology, Eastern Virginia Medical School, Devine-Jordan Center for Reconstructive Surgery and Pelvic Health Urology of Virginia, 225 Clearfield Avenue, Virginia Beach, Norfolk, VA, 23462, USA., McCammon K; Department of Urology, Eastern Virginia Medical School, Devine-Jordan Center for Reconstructive Surgery and Pelvic Health Urology of Virginia, 225 Clearfield Avenue, Virginia Beach, Norfolk, VA, 23462, USA. MccammKA@evms.edu.
Jazyk: angličtina
Zdroj: International urology and nephrology [Int Urol Nephrol] 2021 May; Vol. 53 (5), pp. 907-918. Date of Electronic Publication: 2021 Jan 07.
DOI: 10.1007/s11255-020-02720-7
Abstrakt: Purpose: This study aimed at comparing surgical outcomes and patient-reported donor site morbidity between lingual mucosal graft (LMG) and buccal mucosal graft (BMG) through a meta-analysis of comparative studies.
Methods: A systematic literature search was performed in January 2019 including non-randomized comparative studies and randomized controlled trials (RCT). The assessed data included urethroplasty outcomes, complications, and donor site morbidities such as pain, bleeding, swelling, numbness, difficulty speaking, difficulty eating, mouth opening, and difficulty with tongue protrusion.
Results: A total of 632 patients (LMG 323, BMG 309) from 12 comparative studies (four RCTs and eight non-randomized) were included in the meta-analysis. Overall pooled effect estimates revealed no significant difference on reported surgical outcomes and operative stricture-related complications. The LMG group reported a higher proportion of patients with difficulty speaking (RR 6.96, 95% CI 2.04-23.70) and difficulty with tongue protrusion (RR 12.93, 95% CI 3.07-54.51) within 30 days post-op. In comparison, the BMG group had significantly more incidence of early post-procedural donor site swelling (RR 0.39, 95% CI 0.25-0.61) and numbness within 30 days post-op (RR 0.48, 95% CI 0.23-0.97) and 3-6 months (RR 0.52, 95% CI 0.30-0.90) post-op.
Conclusion: The evidence suggests no overall significant difference between LMG and BMG with regard to urethroplasty outcomes at 1-year follow-up. While patients undergoing LMG urethroplasty have a higher chance of experiencing difficulty with speech and difficulty with tongue protrusion within 1 month of surgery, the BMG group is more likely to experience early donor site swelling and mouth opening difficulty within 30 days post-op, as well as oral numbness for up to 6 months.
Databáze: MEDLINE
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