Comparing Balloon Dilation to Non-Balloon Dilation for Access in Ultrasound-Guided Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis.

IF 3.1 3区 医学 Q1 UROLOGY & NEPHROLOGY
Meixuan Ding, Kai Zhu, Wenzhao Zhang, Haichao Huang, Bo Duan, Jiaxin Zheng, Huiqiang Wang, Tao Wang, Peide Bai, Chen Bin
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Abstract

Purpose: This study aims to evaluate the safety and efficacy of ultrasound-guided balloon dilation compared to non-balloon dilation for percutaneous nephrolithotomy (PCNL).

Materials and methods: A systematic review and meta-analysis were conducted by searching PubMed, EMBASE, and the Cochrane Library. Results were filtered using predefined inclusion and exclusion criteria as described and meta-analysis was performed using Review Manager 5.4 software.

Results: A total of six studies involving 1189 patients who underwent PCNL were included. The meta-analysis results demonstrated that compared to non-balloon dilation, balloon dilation was associated with reduced haemoglobin drop [mean difference (MD) = -0.26, 95% CI = -0.40 ~ -0.12, P = 0.0002], decreased transfusion rate [odds ratio (OR) = 0.47, 95% CI = 0.24 ~ 0.92, P = 0.03], shorter tract establishment time (MD = -1.30, 95% CI = -1.87 ~ -0.72, P < 0.0001) and shorter operation time (MD = -5.23, 95% CI = -10.19 ~ -0.27, P = 0.04).

Conclusions: Overall, ultrasound-guided balloon dilatation offered several advantages in PCNL procedures. It facilitated faster access establishment, as evidenced by shorter access creation time. Additionally, it reduced the risk of kidney injury by minimizing postoperative haemoglobin drop and decreasing the need for transfusions. Moreover, it enhanced the efficiency of surgery by reducing the operation time. However, it is important to note that the quality of some included studies was subpar, as they did not adequately control for confounding factors that may affect the outcomes. Therefore, further research is necessary to validate and strengthen these findings.

比较球囊扩张与非球囊扩张在超声引导下经皮肾镜取石术中的应用:系统回顾与元分析》。
目的:本研究旨在评估经皮肾镜取石术(PCNL)中超声引导下球囊扩张与非球囊扩张相比的安全性和有效性:通过搜索 PubMed、EMBASE 和 Cochrane 图书馆,进行了系统综述和荟萃分析。使用预定义的纳入和排除标准对结果进行过滤,并使用 Review Manager 5.4 软件进行荟萃分析:结果:共纳入六项研究,涉及 1189 名接受 PCNL 的患者。荟萃分析结果表明,与非球囊扩张相比,球囊扩张与减少血红蛋白下降[平均差(MD)= -0.26,95% CI = -0.40 ~ -0.12,P = 0.0002]、减少输血率[几率比(OR)= 0.47,95% CI = 0.24 ~ 0.92,P = 0.03],缩短了建道时间(MD = -1.30 ,95% CI = -1.87 ~ -0.72,P < 0.0001),缩短了手术时间(MD = -5.23,95% CI = -10.19 ~ -0.27,P = 0.04):总体而言,超声引导下球囊扩张术在 PCNL 手术中具有多项优势。它有助于更快地建立通路,通路建立时间更短就是证明。此外,它还能减少术后血红蛋白下降,降低输血需求,从而降低肾损伤风险。此外,它还通过缩短手术时间提高了手术效率。不过,值得注意的是,一些纳入研究的质量不高,因为它们没有充分控制可能影响结果的混杂因素。因此,有必要开展进一步研究,以验证和加强这些研究结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Braz J Urol
International Braz J Urol UROLOGY & NEPHROLOGY-
CiteScore
4.60
自引率
21.60%
发文量
246
审稿时长
6-12 weeks
期刊介绍: Information not localized
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