Gauhar, V., Castellani, D., Cracco, C.M. et al. (12 more authors) (2022) Is endoscopic combined intrarenal surgery ready for primetime in endourology? Outcomes from a systematic review and meta-analysis. Central European Journal of Urology, 75. pp. 171-181. ISSN 0500-7208
Abstract
Introduction We aimed to review the outcomes of endoscopic combined intrarenal surgery (ECIRS) as compared to conventional percutaneous nephrolithotomy (PCNL) for kidney stones.
Material and methods We performed a systematic literature review using MEDLINE, EMBASE, and Co-chrane Central Controlled Register of Trials. We included all studies comparing ECIRS and conventional PCNL. Surgical time, hemoglobin drop, and postoperative stay were pooled using the inverse variance of the mean difference (MD) with a random effect, 95% confidence intervals (CI), and p-values. Compli-cations, stone-free rate, and retreatment were assessed using Cochran-Mantel-Haenszel method with random effect model and expressed as odds ratio (OR), 95% CI, and p-values.
Results A total of 17 studies were included. Surgical time and mean postoperative length did not significantly differ between the groups (MD-8.39 minutes 95%CI-21.30, 4.53, p = 0.20; 5.09 days 95%CI-19.51, 29.69, p = 0.69). Mean hemoglobin drop was significantly lower in the ECIRS group (MD-0.56 g/dl 95%CI-1.08,-0.05, p = 0.03), while blood transfusion rate did not differ between the two groups (OR 0.88 95%CI 0.64, 1.23, p = 0.15). While the incidence of postoperative sepsis did not differ between the two groups (OR 0.52 95% CI 0.17, 1.59, p = 0.25), the incidence of postoperative fever was lower in the ECIRS group but the difference was not significant (OR 0.61 95%CI 0.35, 1.06, p = 0.08). The stone-free rate was significantly higher in the PCNL group (OR 2.52 95%CI 1.64, 3.90, p <0.0001) and the retreat-ment rate was lower in the ECIRS group (OR 0.34 95%CI 0.14, 0.87, p = 0.002).
Conclusions ECIRS showed shorter operative time, lower complication rate, and retreatment compared to PCNL. Conventional PCNL showed a higher stone-free rate.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | This is an open access article under the terms of the Creative Commons Attribution License (CC-BY-NC-SA 4.0), which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. |
Keywords: | percutaneous nephrolithotomy; retrograde intrarenal surgery; kidney stone; endoscopic combined intrarenal surgery |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Medical Research (LIMR) > Division of Haematology and Immunology |
Depositing User: | Symplectic Publications |
Date Deposited: | 20 Feb 2025 13:47 |
Last Modified: | 20 Feb 2025 13:47 |
Status: | Published |
Publisher: | Polish Urological Association |
Identification Number: | 10.5173/ceju.2022.0049 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:223557 |