Mini-percutaneous nephrolithotomy versus flexible ureteroscopic lithotripsy in treatment of lower pole stones : a Meta-analysis / 中华泌尿外科杂志

ABSTRACT

Objective To systematically review the efficacy and safety of mini-percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopic lithotripsy (FURL) in management of lower pole kidney stones.Methods PubMed, Embase, Scopus, Cochrane library, CNKI, VIP and Wanfang Data were searched from the beginning of database to September 2016 and clinical trials that compared the two above operation for treatment of lower pole stones were collected.Two researchers independently filtered literature,extracted data and evaluated the methodological quality of research papers.The meta-analysis was performed using the RevMan 5.3 software.Results One randomized and seven non-randomized studies were analyzed, which consists of 621 patients including MPCNL group 327 cases, FURL group 294 cases.The results of meta-analysis showed that MPCNL was better than FURL in stones clearance (OR =2.65,95％ CI 1.58-4.46,P ＜ 0.01) and operative time (WMD =-21.86,95％ CI-28.52--15.20, P ＜ 0.01).FURL was better in hospital stay time (WMD =2.28,95％ CI 0.29-4.28, P =0.02), decrease in haemoglobin levels (WMD =0.78,95 ％ CI 0.68-0.89, P ＜ 0.01), bleeding (OR =5.11,95 ％ CI 1.12-23.31,P =0.04), transfusion(OR =7.04,95％ CI 1.59-31.15, P =0.01).There was no significant difference in fever,urinary tract infection, hematuria (P ＞ 0.05).Conclusions Both MPCN and FURL are safe and effective for the treatment of lower pole stones, MPCNL can get higher stone clearance rates and shorter operation time.However, FURL can get shorter hospitalization time and lower complication rates.