Surgical patterns in the endoscopic management of pediatric ureterocele: A systematic review and meta-analysis

IF 2 3区医学 Q2 PEDIATRICS

Journal of Pediatric Urology Pub Date : 2024-08-01 DOI:10.1016/j.jpurol.2024.04.005

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引用次数: 0

Abstract

Objective

To assess the results of endoscopic ureterocele treatments as well as the effects of ureterocele location (intravesical vs. ectopic) and anatomy (single vs. duplicated system) on treatment outcomes.

Material and methods

Following the Systematic Reviews and Meta-Analyses (PRISMA) standards, several medical databases as well as Google Scholar were searched comprehensively. Studies describing secondary operation outcomes for endoscopic transurethral incision and puncture were included. Studies were required to compare patients according to ureterocele location (intravesical or ectopic) and anatomy (single or duplex system) or preoperative reflux. Meta-analysis was conducted using Comprehensive Meta-analysis (CMA) software.

Results

A total of 83 studies entered this systematic review consisting of 3022 patients. According to the meta-analysis of 16 studies, the risk ratio (RR) of reoperation after ureterocele incision was significantly higher in patients with ectopic vs. intravesical ureteroceles (RR: 2.42; 95% CI: 1.89–3.11; P < 0.001; I²: 14.89%). Also, a higher reoperation rate was reported in patients with duplex system ureteroceles (DSU) vs. single system ureteroceles (SSU) with little heterogeneity based on 9 studies. (RR: 2.50; 95% CI: 1.60–3.91; P < 0.001; I²: 13.83%).

Conclusion

Our results showed that ectopic ureteroceles and duplex systems are associated with higher reoperation rates after endoscopic procedures.

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内窥镜治疗小儿输尿管结石的手术模式：系统回顾和元分析

材料和方法按照系统综述和荟萃分析（PRISMA）标准，对多个医学数据库和谷歌学术进行了全面检索。纳入了描述内镜下经尿道切开和穿刺术二次手术结果的研究。研究需要根据输尿管膀胱位置（膀胱内或异位）、解剖结构（单一或双相系统）或术前反流情况对患者进行比较。使用综合荟萃分析（CMA）软件进行了荟萃分析。结果共有83项研究参加了此次系统性综述，其中包括3022名患者。根据 16 项研究的荟萃分析，异位输尿管膀胱患者与膀胱内输尿管膀胱患者相比，输尿管膀胱切开术后再次手术的风险比（RR）明显更高（RR：2.42；95% CI：1.89-3.11；P <；0.001；I2：14.89%）。此外，根据 9 项研究的结果显示，双相系统输尿管结石（DSU）与单相系统输尿管结石（SSU）患者的再手术率较高，且异质性很小。(结论我们的研究结果表明，异位输尿管和双相系统与内镜手术后较高的再手术率有关。

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

Journal of Pediatric Urology PEDIATRICS-UROLOGY & NEPHROLOGY

CiteScore

3.70

自引率

15.00%

发文量

330

审稿时长

4-8 weeks

期刊介绍： The Journal of Pediatric Urology publishes submitted research and clinical articles relating to Pediatric Urology which have been accepted after adequate peer review. It publishes regular articles that have been submitted after invitation, that cover the curriculum of Pediatric Urology, and enable trainee surgeons to attain theoretical competence of the sub-specialty. It publishes regular reviews of pediatric urological articles appearing in other journals. It publishes invited review articles by recognised experts on modern or controversial aspects of the sub-specialty. It enables any affiliated society to advertise society events or information in the journal without charge and will publish abstracts of papers to be read at society meetings.