Tseng Timothy Y, Preminger Glenn M
University of Texas Health Science Center at San Antonio, San Antonio, TX, US.
BMJ Clin Evid. 2015 Oct 30;2015:2003.
The age of peak incidence for stone disease is 20 to 40 years, although stones are seen in all age groups. There is a male to female ratio of 3:2.
We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of flexible ureteroscopy for the removal of renal stones? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).
At this update, searching of electronic databases retrieved 197 studies. After deduplication and removal of conference abstracts, 118 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 99 studies and the further review of 18 full publications. Of the 18 full articles evaluated, one systematic review and four RCTs were added at this update. We performed a GRADE evaluation for eight PICO combinations.
In this systematic overview, we categorised the efficacy for four interventions, based on information relating to the effectiveness and safety of: flexible ureteroscopy (combined with snare or basket or laser lithotripsy) versus expectant management, flexible ureteroscopy (combined with snare or basket or laser lithotripsy) versus extracorporeal shockwave lithotripsy, flexible ureteroscopy (combined with snare or basket or laser lithotripsy) versus percutaneous nephrolithotomy.
结石病的发病高峰年龄为20至40岁，不过各年龄组均可见到结石患者。男女比例为3:2。
我们进行了一项系统综述，旨在回答以下临床问题：软性输尿管镜取石术的效果如何？我们检索了：截至2014年5月的医学期刊数据库（Medline）、荷兰医学文摘数据库（Embase）、考克兰图书馆及其他重要数据库（临床证据综述会定期更新；请查看我们的网站获取此综述的最新版本）。
在此次更新时，检索电子数据库共获得197项研究。在去除重复及会议摘要后，筛选出118条记录纳入综述。对标题和摘要进行评估后排除了99项研究，对18篇全文进行了进一步审查。在此次更新时，对所评估的18篇全文中，新增了一项系统评价和四项随机对照试验。我们对八个PICO组合进行了GRADE评估。
在本系统综述中，我们根据以下方面的有效性和安全性信息，对四种干预措施的疗效进行了分类：软性输尿管镜检查（联合圈套器或网篮或激光碎石术）与观察等待、软性输尿管镜检查（联合圈套器或网篮或激光碎石术）与体外冲击波碎石术、软性输尿管镜检查（联合圈套器或网篮或激光碎石术）与经皮肾镜取石术。
