Flexible versus rigid ureteroscopy in the management of proximal ureteric calculi: a systematic review and meta-analysis from EAU Endourology comparing perioperative outcomes and complication rates.

IF 2.2 3区医学 Q2 UROLOGY & NEPHROLOGY

Current Opinion in Urology Pub Date : 2025-06-24 DOI:10.1097/MOU.0000000000001311

Orla Cullivan, Sorcha O'Meara, Cian M Hehir, Rob Geraghty, Olivier Traxer, Bhaskar Somani, Niall F Davis

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引用次数: 0

Abstract

Purpose of review: Urolithiasis is a common condition, with an increasing prevalence. Rigid ureteroscopy (rURS) and flexible ureteroscopy (fURS) are two management approaches for proximal ureteric calculi. The aim of this systematic review and meta-analysis was to compare perioperative outcomes in rURS versus fURS in the management of proximal ureteric calculi.

Recent findings: This systematic review was conducted according to PRISMA guidelines. Systematic search of online databases was performed in November 2024. A combination of MeSH and free text terms were applied. Primary outcome was stone free status. Secondary outcomes included operative time, complication rates, and hospital stay. Six studies met inclusion criteria, in which a total of 1085 patients underwent ureteroscopy (fURS, n = 537 versus rURS, n = 548). Five studies were retrospective comparative, one was prospective randomized comparative. FURS use was associated with significantly superior stone free rates (92%) when compared with rURS (84.5%) (P < 0.001). Secondary outcomes of complication rates (P = 0.17), length of stay (P = 0.39), and operative time (P = 0.08) did not reach statistical significance.

Summary: Both rURS and fURS have acceptable stone clearance and complication rates for managing proximal ureteric calculi. Regarding stone clearance, fURS is superior to rURS, both interventions are comparable with regards to complications, operative time, and hospital stay.

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柔性输尿管镜与刚性输尿管镜在输尿管近端结石治疗中的应用：一项来自EAU Endourology的系统综述和荟萃分析，比较围手术期结果和并发症发生率。

综述目的：尿石症是一种常见病，发病率呈上升趋势。硬输尿管镜和软输尿管镜是输尿管近端结石的两种治疗方法。本系统综述和荟萃分析的目的是比较rURS与fURS治疗输尿管近端结石的围手术期结果。最新发现：本系统综述是根据PRISMA指南进行的。2024年11月进行了在线数据库的系统搜索。应用了MeSH和自由文本术语的组合。主要终点为无结石状态。次要结局包括手术时间、并发症发生率和住院时间。6项研究符合纳入标准，共1085例患者接受输尿管镜检查（fURS, n = 537 vs rURS, n = 548）。5项研究为回顾性比较，1项为前瞻性随机比较。与rURS（84.5%）相比，使用FURS的结石清除率（92%）显著高于rURS (84.5%) (P总结：rURS和FURS治疗输尿管近端结石的结石清除率和并发症发生率均可接受。关于结石清除，fURS优于rURS，两种干预措施在并发症、手术时间和住院时间方面是相当的。

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

Current Opinion in Urology 医学-泌尿学与肾脏学

CiteScore

5.00

自引率

4.00%

发文量

140

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Urology delivers a broad-based perspective on the most recent and most exciting developments in urology from across the world. Published bimonthly and featuring ten key topics – including focuses on prostate cancer, bladder cancer and minimally invasive urology – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.