Minimally Invasive Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery for Upper Urinary Stones: A Systematic Review and Meta-AnalysisReportar como inadecuado




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BioMed Research International - Volume 2017 2017, Article ID 2035851, 14 pages - https:-doi.org-10.1155-2017-2035851

Review ArticleDepartment of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei 430030, China

Correspondence should be addressed to Zhuo Liu and Jihong Liu

Received 12 January 2017; Accepted 5 April 2017; Published 3 May 2017

Academic Editor: Christian Schwentner

Copyright © 2017 Hongyang Jiang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Minimally invasive percutaneous nephrolithotomy mini-PCNL and retrograde intrarenal surgery RIRS are both alternatives for PCNL to treat renal calculi. This study is aimed at comparing the stone-free rate SFR and other surgery parameters of two approaches for treating upper urinary calculi. We performed this meta-analysis in September 2016 by searching studies about mini-PCNL and RIRS for treating upper urinary calculi in various databases, and RevMan v.5.3 was applied. Three randomized controlled trials and ten nonrandomized trials were included, involving a total of 1317 patients. Meta-analysis showed that mini-PCNL group led to a higher SFR odds ratio: 1.96; 95% confidence interval: 1.46–2.64; but brought a larger postoperative decrease in hemoglobin levels compared with RIRS. RIRS provided a shorter hospital time. There was no significant difference in operation time. Higher postoperative complications were detected in the mini-PCNL, but the difference was not significant. Grade I and III complications did not vary between two procedures, but grade II complications were of lower incidence in RIRS group. In the light of these results, compared with RIRS, mini-PCNL provided significantly higher SFR and efficiency quotient for managing calculi; however, it resulted in higher incidence of postoperative complications, larger hemoglobin drops, and longer hospital stay.





Autor: Hongyang Jiang, Zhe Yu, Liping Chen, Tao Wang, Zhuo Liu, Jihong Liu, Shaogang Wang, and Zhangqun Ye

Fuente: https://www.hindawi.com/



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