Comparison of the efficacy and safety of mini-percutaneous nephrolithotomy versus retrograde intrarenal surgery for the treatment of kidney stones in overweight or obese patients: a systematic review and meta-analysis.

IF 1.7 3区医学 Q3 UROLOGY & NEPHROLOGY

BMC Urology Pub Date : 2024-11-06 DOI:10.1186/s12894-024-01588-4

Ming Qiu, Hongjin Shi, Fabin Yang, Pingchu Li, Shi Fu, Jiansong Wang, Haifeng Wang, Qiao Yang, Yigang Zuo, Bing Hai, Jinsong Zhang

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引用次数: 0

Abstract

Objective: To discuss the differences in the effectiveness and security of kidney stones in overweight or obese patients by mini percutaneous nephrolithotomy (MiniPCNL) and retrograde intrarenal surgery (RIRS).

Materials and methods: We exhaustively searched numerous databases, including PubMed, Embase, Web of Science, Cochrane Library, and CNKI, covering all records from their initiation date until September 2023. This included controlled trials focusing on the use of MiniPCNL and RIRS in the treatment of kidney stones in overweight or obese patients. The gathered data was then analyzed using the Review Manager 5.4 software.

Results: 9 studies including 1122 patients were included. Meta-analysis showed that: The MiniPCNL group had higher overall complications, grade I complications, length of hospital stay(LOS), first stone-free rate (SFR), and final SFR in obese patients, with no significant difference between the two groups in terms of operative time(OT), hemoglobin drop, and grade II complication rate. There were more overall complications, grade I complications, final SFR, and LOS with MiniPCNL in patients with stones > 2 cm compared to no significant difference in grade II complications. MiniPCNL performed in the prone position had higher final SFR, less OT, hemoglobin drop, and no statistically significant difference in overall complications or LOS. Sheaths using > 14 F had higher overall complication rates, final SFR, and LOS, and no statistical differences in OT and first SFR between the two modalities. In the MiniPCNL subgroup aged ≤ 50 years, there were higher first SFR, final SFR, and shorter OT, and in the MiniPCNL subgroup aged > 50 years, there were more OT, LOS, and hemoglobin drop, with no statistical difference in overall complications between the two groups.

Conclusion: Our study showed that MiniPCNL in obese patients had higher initial SFR and final SFR, fewer procedures, but more postoperative complications, LOS, and grade I complications compared with RIRS. Similar results were seen in patients in the prone position, with stones > 2 cm and age ≤ 50 years.

Systematic review registration: [ https://www.crd.york.ac.uk/PROSPERO/ ], identifier PROSPERO (CRD42023467284).

查看原文本刊更多论文

比较迷你经皮肾镜取石术与逆行肾内手术治疗超重或肥胖患者肾结石的疗效和安全性：系统综述和荟萃分析。

目的探讨迷你经皮肾镜取石术（MiniPCNL）和逆行肾内手术（RIRS）治疗超重或肥胖患者肾结石的有效性和安全性差异：我们详尽检索了众多数据库，包括PubMed、Embase、Web of Science、Cochrane Library和CNKI，涵盖了从开始日期到2023年9月的所有记录。其中包括关于使用 MiniPCNL 和 RIRS 治疗超重或肥胖患者肾结石的对照试验。然后使用 Review Manager 5.4 软件对收集到的数据进行分析：结果：共纳入 9 项研究，包括 1122 名患者。元分析表明MiniPCNL 组肥胖患者的总体并发症、I 级并发症、住院时间（LOS）、首次无石率（SFR）和最终无石率（SFR）均高于 MiniPCNL 组，两组在手术时间（OT）、血红蛋白下降和 II 级并发症发生率方面无显著差异。在结石大于 2 厘米的患者中，MiniPCNL 的总体并发症、I 级并发症、最终 SFR 和 LOS 均较多，而 II 级并发症则无明显差异。俯卧位进行 MiniPCNL 的最终 SFR 较高、OT 较低、血红蛋白下降较少，但总体并发症或 LOS 无明显统计学差异。使用大于 14 F 的鞘时，总并发症发生率、最终 SFR 和 LOS 均较高，两种方式的 OT 和首次 SFR 无统计学差异。在年龄小于 50 岁的 MiniPCNL 亚组中，首次 SFR 和最终 SFR 较高，OT 较短，而在年龄大于 50 岁的 MiniPCNL 亚组中，OT、LOS 和血红蛋白下降较多，两组在总体并发症方面无统计学差异：我们的研究表明，与 RIRS 相比，肥胖患者的 MiniPCNL 的初始 SFR 和最终 SFR 较高，手术次数较少，但术后并发症、LOS 和 I 级并发症较多。在俯卧位、结石大于 2 厘米、年龄小于 50 岁的患者中也有类似的结果：[ https://www.crd.york.ac.uk/PROSPERO/ ]，标识符为 PROSPERO (CRD42023467284)。

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

BMC Urology UROLOGY & NEPHROLOGY-

CiteScore

3.20

自引率

0.00%

发文量

177

审稿时长

>12 weeks

期刊介绍： BMC Urology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of urological disorders, as well as related molecular genetics, pathophysiology, and epidemiology. The journal considers manuscripts in the following broad subject-specific sections of urology: Endourology and technology Epidemiology and health outcomes Pediatric urology Pre-clinical and basic research Reconstructive urology Sexual function and fertility Urological imaging Urological oncology Voiding dysfunction Case reports.