Fauzan Randy, Herman Hendra, Rachman Wendy, Sitompul Ardiansyah Periadi, Astram Ari
Urology Division, Department of Surgery, School of Medicine, Raden Mattaher Hospital, Universitas Jambi, Jambi, Jambi, 36121, Indonesia.
Urology Division, Department of Surgery, School of Medicine, Universitas Jambi, Abdul Manap Hospital, Jambi, Jambi, 36129, Indonesia.
F1000Res. 2023 Feb 2;12:124. doi: 10.12688/f1000research.129270.1. eCollection 2023.
The treatment of choice for bladder stones in children remains debatable. This study aimed to compare the outcomes of endourological and open cystolithotomy for the management of bladder stones in children. The Medline, Embase, Cochrane controlled trial databases and clinicaltrials.gov were searched for relevant English-language publications from 1 to 30 August 2022. Stone-free rate (SFR), complication rate, length of stay, and procedure duration were compared. Children (male and female) <18 years of age of any ethnicity with bladder stones (single/multiple) were included. Patients with a history of bladder augmentation or diversion were excluded. The quality of studies included was assessed using Cochrane's Risk of Bias Assessment. The meta-analysis was performed using RevMan. Five articles (436 participants) that compared endourological open cystolithotomy were included in qualitative and quantitative analyses. Four were non-randomised, retrospective, and single centre studies. While the other one was a randomised controlled trial. Measure outcome characteristics included SFR, complications, procedure duration, and length of hospital stay. There was no significant difference in the SFR between transurethral cystolithotripsy (TUCL) and percutaneous cystolithotomy (PCCL) ( 0.22). There were also no significant differences in complications (TUCL PCCL, 0.18; TUCL open cystolithotomy [CL] and PCCL CL, 0.08). PCCL featured a longer procedure duration than TUCL ( 0.00001), while CL was shorter than TUCL and PCCL (both 0.00001). Finally, in terms of length of stay, TUCL was superior to PCCL and CL, while PCCL was better than CL (all 0.00001). Endourological and open surgical management of bladder stones in children showed comparable SFR and fewer complications. Open surgery offers a shorter procedure duration than endourological management, but PCCL features a shorter procedure duration than TUCL. In terms of length of stay, TUCL and PCCL were superior to CL, while TUCL was better than PCCL.
儿童膀胱结石的首选治疗方法仍存在争议。本研究旨在比较腔内泌尿外科手术和开放性膀胱切开取石术治疗儿童膀胱结石的效果。检索了Medline、Embase、Cochrane对照试验数据库和clinicaltrials.gov，以查找2022年8月1日至30日期间相关的英文出版物。比较了结石清除率（SFR）、并发症发生率、住院时间和手术时长。纳入了年龄<18岁、任何种族、患有膀胱结石（单发/多发）的儿童（男童和女童）。排除有膀胱扩大或改道病史的患者。使用Cochrane偏倚风险评估对纳入研究的质量进行评估。使用RevMan进行荟萃分析。五项比较腔内泌尿外科手术和开放性膀胱切开取石术的文章（436名参与者）纳入了定性和定量分析。四项为非随机、回顾性、单中心研究。另一项为随机对照试验。测量的结果特征包括结石清除率、并发症、手术时长和住院时间。经尿道膀胱碎石术（TUCL）和经皮膀胱碎石术（PCCL）之间的结石清除率无显著差异（0.22）。并发症方面也无显著差异（TUCL与PCCL，0.18；TUCL与开放性膀胱切开取石术[CL]以及PCCL与CL，0.08）。PCCL的手术时长比TUCL长（0.00001），而CL比TUCL和PCCL短（均为0.00001）。最后，在住院时间方面，TUCL优于PCCL和CL，而PCCL优于CL（均为0.00001）。儿童膀胱结石的腔内泌尿外科手术和开放手术治疗显示出相当的结石清除率且并发症较少。开放手术的手术时长比腔内泌尿外科手术短，但PCCL的手术时长比TUCL短。在住院时间方面，TUCL和PCCL优于CL，而TUCL优于PCCL。
