{"title":"超声与透视引导下经皮肾镜取石术治疗肾结石的有效性和安全性：随机对照试验的系统回顾和荟萃分析。","authors":"Ruoyang Du, Wubing Feng, Tong Yi","doi":"10.1016/j.urology.2024.11.025","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness and safety of ultrasound-guided percutaneous nephrolithotomy (UG-PCNL) compared to fluoroscopy-guided PCNL (FG-PCNL) for kidney stone management, focusing on clinical outcomes and procedural efficiency.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following PRISMA guidelines. Searches were performed in PubMed, EMBASE, Scopus, and Web of Science for studies published between 2000 and 2024. Primary outcomes included stone-free rate (SFR), needle puncture time (NPT), calculus clearance rate (CCR), and access time. Secondary outcomes involved single needle puncture success rate (SNPSR), hospital stay duration (HSD), total complication rate (TCR), urosepsis, fever and postoperative serum creatinine.</p><p><strong>Results: </strong>Analysis of 21 RCTs with 2969 patients showed no significant difference in SFR between UG-PCNL and FG-PCNL (OR: 0.93, 95% CI: 0.77-1.13; p = 0.47). UG-PCNL significantly reduced access time (SMD: 0.68, 95% CI: 0.06-1.30; p = 0.03), while other outcomes like SNPSR and puncture time showed no significant differences. Complication rates, including urosepsis and fever, were comparable between techniques.</p><p><strong>Conclusions: </strong>UG-PCNL is as effective as FG-PCNL, offering the benefits of radiation-free imaging and reduced access time, with comparable safety profiles. Further studies are needed to confirm the certainty of outcomes like SNPSR and bleeding rates.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy and safety of ultrasound- vs fluoroscopy-guided percutaneous nephrolithotomy in managing renal calculi: A systematic review and meta-analysis of randomized controlled trials.\",\"authors\":\"Ruoyang Du, Wubing Feng, Tong Yi\",\"doi\":\"10.1016/j.urology.2024.11.025\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the effectiveness and safety of ultrasound-guided percutaneous nephrolithotomy (UG-PCNL) compared to fluoroscopy-guided PCNL (FG-PCNL) for kidney stone management, focusing on clinical outcomes and procedural efficiency.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following PRISMA guidelines. Searches were performed in PubMed, EMBASE, Scopus, and Web of Science for studies published between 2000 and 2024. Primary outcomes included stone-free rate (SFR), needle puncture time (NPT), calculus clearance rate (CCR), and access time. Secondary outcomes involved single needle puncture success rate (SNPSR), hospital stay duration (HSD), total complication rate (TCR), urosepsis, fever and postoperative serum creatinine.</p><p><strong>Results: </strong>Analysis of 21 RCTs with 2969 patients showed no significant difference in SFR between UG-PCNL and FG-PCNL (OR: 0.93, 95% CI: 0.77-1.13; p = 0.47). UG-PCNL significantly reduced access time (SMD: 0.68, 95% CI: 0.06-1.30; p = 0.03), while other outcomes like SNPSR and puncture time showed no significant differences. Complication rates, including urosepsis and fever, were comparable between techniques.</p><p><strong>Conclusions: </strong>UG-PCNL is as effective as FG-PCNL, offering the benefits of radiation-free imaging and reduced access time, with comparable safety profiles. Further studies are needed to confirm the certainty of outcomes like SNPSR and bleeding rates.</p>\",\"PeriodicalId\":23415,\"journal\":{\"name\":\"Urology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-11-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Urology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.urology.2024.11.025\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.urology.2024.11.025","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Efficacy and safety of ultrasound- vs fluoroscopy-guided percutaneous nephrolithotomy in managing renal calculi: A systematic review and meta-analysis of randomized controlled trials.
Objective: To evaluate the effectiveness and safety of ultrasound-guided percutaneous nephrolithotomy (UG-PCNL) compared to fluoroscopy-guided PCNL (FG-PCNL) for kidney stone management, focusing on clinical outcomes and procedural efficiency.
Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following PRISMA guidelines. Searches were performed in PubMed, EMBASE, Scopus, and Web of Science for studies published between 2000 and 2024. Primary outcomes included stone-free rate (SFR), needle puncture time (NPT), calculus clearance rate (CCR), and access time. Secondary outcomes involved single needle puncture success rate (SNPSR), hospital stay duration (HSD), total complication rate (TCR), urosepsis, fever and postoperative serum creatinine.
Results: Analysis of 21 RCTs with 2969 patients showed no significant difference in SFR between UG-PCNL and FG-PCNL (OR: 0.93, 95% CI: 0.77-1.13; p = 0.47). UG-PCNL significantly reduced access time (SMD: 0.68, 95% CI: 0.06-1.30; p = 0.03), while other outcomes like SNPSR and puncture time showed no significant differences. Complication rates, including urosepsis and fever, were comparable between techniques.
Conclusions: UG-PCNL is as effective as FG-PCNL, offering the benefits of radiation-free imaging and reduced access time, with comparable safety profiles. Further studies are needed to confirm the certainty of outcomes like SNPSR and bleeding rates.
期刊介绍：
Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology
The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.
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