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Comparison of mini percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for renal stones >2cm: a systematic review and meta-analysis
Qin, Pengfei; Zhang, Dong; Huang, Ting; Fang, Li; Cheng, Yue.
  • Qin, Pengfei; Ningbo University. School of Medicine. Ningbo. CN
  • Zhang, Dong; Ningbo University. School of Medicine. Ningbo. CN
  • Huang, Ting; Ningbo First Hospital. The Center for Uro-nephrological Diseases. Department of Urology. Ningbo. CN
  • Fang, Li; Ningbo First Hospital. The Center for Uro-nephrological Diseases. Department of Urology. Ningbo. CN
  • Cheng, Yue; Ningbo First Hospital. The Center for Uro-nephrological Diseases. Department of Urology. Ningbo. CN
Int. braz. j. urol ; 48(4): 637-648, July-Aug. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1385134
ABSTRACT
ABSTRACT Background The purpose is to compare the efficacy and safety of mini percutaneous nephrolithotomy (mini-PCNL) versus standard percutaneous nephrolithotomy (standard-PCNL) in patients with renal stones >2cm. Materials and Methods A systematic literature search was conducted in PubMed, Web of Science, Scopus, and the Cochrane Library databases to identify relevant studies before March 8, 2021. Stone-free rate (SFR), operation time, fever rate, hemoglobin drop, blood transfusion rate, and hospitalization time were used as outcomes to compare mini-PCNL and standard-PCNL. The meta-analysis was performed using the Review Manager version 5.4. Results Seven randomized controlled trials were included in our meta-analysis, involving 1407 mini-PCNL cases and 1436 standard-PCNL cases. Our results reveal that, for renal stones >2cm, mini-PCNL has a similar SFR (risk ratio (RR)=1.01, 95% confidence interval (CI) 0.98 to 1.04, p=0.57) and fever rate (RR=1.22, 95% CI 0.97-1.51, p=0.08). Standard-PCNL was associated with a significantly shorter operating time (weighted mean difference (WMD)=8.23, 95% CI 3.44 to 13.01, p <0.01) and a longer hospitalization time (WMD=-20.05, 95% CI -29.28 to -10.81, p <0.01) than mini-PCNL. Subgroup analysis showed hemoglobin drop and blood transfusion for 30F standard-PCNL were more common than mini-PCNL (WMD=-0.95, 95% CI -1.40 to -0.50, p <0.01; RR=0.20, 95% CI 0.07 to 0.58, p <0.01). Conclusion In the treatment of >2cm renal stones, mini-PCNL should be considered an effective and reliable alternative to standard-PCNL (30F). It achieves a comparable SFR to standard-PCNL, but with less blood loss, lower transfusion rate, and shorter hospitalization. However, the mini-PCNL does not show a significant advantage over the 24F standard-PCNL. On the contrary, this procedure takes a longer operation time. Trial registration This meta-analysis was reported consistent with the PRISMA statement and was registered on PROSPERO, with registration number 2021CRD42021234893.


Full text: Available Index: LILACS (Americas) Type of study: Controlled clinical trial / Systematic reviews Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2022 Type: Article / Project document Affiliation country: China Institution/Affiliation country: Ningbo First Hospital/CN / Ningbo University/CN

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Full text: Available Index: LILACS (Americas) Type of study: Controlled clinical trial / Systematic reviews Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2022 Type: Article / Project document Affiliation country: China Institution/Affiliation country: Ningbo First Hospital/CN / Ningbo University/CN