|
KMID : 1011820200610020115
|
|
Investigative and Clinical Urology
2020 Volume.61 No. 2 p.115 ~ p.126
|
|
|
The efficacy and safety of miniaturized percutaneous nephrolithotomy versus standard percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized controlled trials
|
|
Feng Dechao
Hu Xiao
Tang Yin
Han Ping
Wei Xin
|
|
|
Abstract
|
|
|
Purpose: Our aim was to assess the efficacy and safety of miniaturized percutaneous nephrolithotomy (mPCNL) versus standard PCNL (sPCNL) to provide higher-level evidence.
Materials and Methods: Eligible randomized controlled trials were identified from electronic databases. The data analysis was performed by the Cochrane Collaboration's software RevMan 5.3.
Results: A total of 1,219 patients from 9 articles published between 2004 and 2019 were included. Compared with those who received sPCNL, patients who received mPCNL experienced a higher stone-free rate (SFR) (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.03?1.99; p=0.03), lower transfusion rates (OR, 0.33; 95% CI, 0.17?0.63; p=0.0007), and lower drops in hemoglobin (mean difference [MD], ?0.72; 95% CI, ?1.04 to ?0.40; p<0.00001), but the operative time seemed to be significantly longer (MD, 10.98; 95% CI, 3.64?18.32; p=0.003). Of note, there was no significant difference between the two groups regarding the SFR (p=0.09) for renal calculi ≥2 cm. In addition, the meta-analysis results showed no significant differences between the groups regarding urine leakage (p=0.60), postoperative fever (p=0.71), impaired ventilation (p=0.97), or total complications (p=0.29) with no heterogeneity between trials. These results remain unaffected with regard to renal calculi ≥2 cm.
Conclusions: Our findings suggested that mPCNL had a higher SFR than sPCNL and there was no significant difference between the two groups for renal stones ≥2 cm. Besides, mPCNL tended to be associated with significantly less bleeding and a lower transfusion rate, but the duration of the procedure seemed to be significantly longer.
|
|
|
KEYWORD
|
|
|
Meta-analysis, Minimally invasive surgical procedures, Nephrolithotomy, percutaneous, Randomized controlled trial
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
    
|
|