Department of Urology, New York University School of Medicine, New York, New York 10016, USA.
J Endourol. 2010 Sep;24(9):1411-4. doi: 10.1089/end.2009.0645.
There is no standardization in the nephrolithiasis literature regarding preoperative or postoperative evaluation of patients who are undergoing treatment for stone disease. This may hinder comparisons of efficacy of different treatment modalities. We evaluated heterogeneity in the literature of preoperative and postoperative evaluations of patients who were undergoing surgical treatment for nephrolithiasis.
A systematic PubMed search was performed for 2006 to 2008 using search terms kidney stones, ureteral stones, nephrolithiasis, ureterolithiasis, ureteroscopy (URS), shockwave lithotripsy (SWL), and percutaneous nephrolithotomy (PCNL). Articles that evaluated treatment outcomes were included, and information regarding preoperative and postoperative evaluation was collected.
One hundred and fifty-four studies were included. Preoperative stone burden was evaluated using CT (42), ultrasonography (US) (42), plain radiography of the kidneys, ureters, and bladder (KUB) (92), multiple modalities (52), and no mention (45). Stone burden was reported as maximum diameter (105), surface area (32), volume (6), other (1), and no mention (10). Treatment modalities included URS (46), PCNL (71), SWL (50), and multiple modalities (9). Postoperative imaging included CT (37), US (67), KUB (115), multiple modalities (70), other (11) and no mention (19). Radiographic outcomes included strict stone free (114) and presence of residual fragments (RF) (64). There was wide variation in the size of RF reported (<1 mm through <7 mm). "Stone free" included the presence of RF in 18 studies. Treatment "success" was defined to include RF of various sizes. Reported clinical outcomes included stone-related events (46) and surgery (90).
There is extensive variability in the reporting of preoperative disease characteristics and postoperative outcomes in studies that evaluate treatments for nephrolithiasis. Standardization of these criteria is essential for more meaningful comparisons of treatment modalities and outcomes for different disease subgroups.
在接受结石病治疗的患者的术前或术后评估方面，肾结石文献中没有标准化。这可能会妨碍对不同治疗方式疗效的比较。我们评估了接受肾结石外科治疗的患者的术前和术后评估文献中的异质性。
使用肾石症、输尿管结石、肾结石、输尿管结石、输尿管镜检查（URS）、体外冲击波碎石术（SWL）和经皮肾镜取石术（PCNL）等检索词，对 2006 年至 2008 年的 PubMed 进行了系统检索。纳入评估治疗结果的文章，并收集了术前和术后评估的信息。
共纳入 154 项研究。术前结石负荷通过 CT（42）、超声（US）（42）、肾脏、输尿管和膀胱的 KUB 平片（92）、多种方式（52）和未提及（45）进行评估。结石负荷报告为最大直径（105）、表面积（32）、体积（6）、其他（1）和未提及（10）。治疗方式包括 URS（46）、PCNL（71）、SWL（50）和多种方式（9）。术后影像学检查包括 CT（37）、US（67）、KUB（115）、多种方式（70）、其他（11）和未提及（19）。放射学结果包括严格的无结石（114）和残余碎片（RF）（64）。报告的 RF 大小差异很大（<1 毫米至<7 毫米）。18 项研究中“无结石”包括 RF 的存在。将治疗“成功”定义为包括各种大小的 RF。报告的临床结果包括结石相关事件（46）和手术（90）。
在评估肾结石治疗方法的研究中，术前疾病特征和术后结果的报告存在广泛的差异。这些标准的标准化对于不同疾病亚组的治疗方式和结果的更有意义的比较至关重要。
