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微通道经皮肾镜取石术与微创经皮肾镜取石术治疗肾结石的比较:一项系统评价和荟萃分析

Comparison of Micro-Percutaneous and Mini-Percutaneous Nephrolithotomy in the Treatment of Renal Stones: A Systematic Review and Meta-Analysis.

作者信息

Gao Xiaoshuai, Wang Wei, Peng Liao, Di Xingpeng, Xiao Kaiwen, Chen Jixiang, Jin Tao

机构信息

Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China.

出版信息

Front Surg. 2021 Oct 4;8:743017. doi: 10.3389/fsurg.2021.743017. eCollection 2021.

Abstract

To assess the efficacy and safety of micro-percutaneous nephrolithotomy (Microperc) and mini-percutaneous nephrolithotomy (Miniperc) in the treatment of moderately sized renal stones. Literature search of PubMed, Web of Science, and Embase was performed prior to January 2021. We used odds ratios (OR) and weighted mean difference (WMD) for dichotomous variables and continuous variables, respectively. Results were pooled using Review Manager version 5.3 software. A total of six studies involving 291 Microperc and 328 Miniperc cases was included. The overall stone-free rate (SFR) of Microperc was 87.29% (254/291), while the SFR of Miniperc was 86.59% (284/328). Microperc was associated with lower hemoglobin drop (WMD: -0.98; = 0.03) and higher renal colic requiring D-J stent insertion (OR: 3.49; = 0.01). No significant differences existed between Microperc and Miniperc with respect to SFR (OR: 1.10; = 0.69), urinary tract infection (OR: 0.38; = 0.18), operative time (WMD: -5.76; = 0.62), and hospital stay time (WMD: -1.04; = 0.07). Our meta-analysis demonstrated that Microperc could produce an SFR that was comparable with that of Miniperc. Microperc was associated with lower hemoglobin drop, while Miniperc was associated with lower renal colic rates. In addition, the operation time and hospital stay time for both these procedures were similar.

摘要

评估微通道经皮肾镜取石术(Microperc)和迷你通道经皮肾镜取石术(Miniperc)治疗中等大小肾结石的疗效和安全性。在2021年1月之前对PubMed、科学网和Embase进行了文献检索。我们分别对二分变量和连续变量使用比值比(OR)和加权平均差(WMD)。使用Review Manager 5.3版软件汇总结果。总共纳入了六项研究,涉及291例Microperc病例和328例Miniperc病例。Microperc的总体无石率(SFR)为87.29%(254/291),而Miniperc的SFR为86.59%(284/328)。Microperc与较低的血红蛋白下降相关(WMD:-0.98;P = 0.03),且需要插入D-J支架的肾绞痛发生率较高(OR:3.49;P = 0.01)。在SFR(OR:1.10;P = 0.69)、尿路感染(OR:0.38;P = 0.18)、手术时间(WMD:-5.76;P = 0.62)和住院时间(WMD:-1.04;P = 0.07)方面,Microperc和Miniperc之间没有显著差异。我们的荟萃分析表明,Microperc的无石率与Miniperc相当。Microperc与较低的血红蛋白下降相关,而Miniperc与较低的肾绞痛发生率相关。此外,这两种手术的手术时间和住院时间相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77d7/8522995/af9d2d523558/fsurg-08-743017-g0001.jpg

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