摘要
目的系统评价后腹腔镜肾盂切开取石术(RLP)与经皮肾镜取石术(PCNL)治疗肾盂单发结石的安全性与有效性。方法检索PubMed、EMBASE、Cochrane Library、Science Direct、中国生物医学文献数据库(CBM)、中文期刊全文数据库(CNKI)和万方数据库,纳入关于两种术式的所有对照性研究,包括随机对照研究、队列研究及病例对照研究。采用RevMan 5.3软件对两组数据进行统计分析。结果共纳入11项研究,包括2项随机对照研究与9项病例对照研究。Meta分析结果显示,RLP组较PCNL组手术时间延长(WMD=18.93,P=0.009),住院时间缩短(WMD=-1.09,P<0.001),术中出血量减少(WMD=-46.48,P<0.001),结石清除率更高(RR=1.21,P<0.001),术后发热率(RR=0.41,P<0.001)、输血率(RR=0.23,P=0.003)及其他并发症发生率更低(RR=0.32,P<0.001),差异均有统计学意义。然而,两组的术后尿漏率比较,差异无统计学意义(RR=1.13,P=0.730)。结论RLP治疗肾盂单发结石在结石清除率、住院时间、术中出血量和术后发热及术后输血等并发症发生率方面均优于PCNL。
Objective To compare the safety and efficacy of retroperitoneal laparoscopic pyelolithotomy(RLP)with percutaneous nephrolithotomy(PCNL)for the treatment of solitary renal pelvic stone.Methods PubMed,EMBASE,Cochrane Library and ScienceDirect were searched for collecting related literatures on two procedures.All compared studies,including randomized controlled trials(RCT),cohort studies(CS)and case-control studies(CCS)were included.Results Totally,11 studies(2 RCTs and 9 CCSs)were included.Pooled data demonstrated that patients underwent RLP were associated with significantly longer operation time[weighted mean difference(WMD)=18.93,P=0.009],shorter hospital stay(WMD=-1.09,P<0.001),less intraoperative blood loss(WMD=-46.48,P<0.001),higher stonefree rate[risk ratio(RR)=1.21,P<0.001],lower postoperative fever rate(RR=0.41,P<0.001),lower transfusion rate(RR=0.23,P=0.003)and other complications(RR=0.32,P<0.001),the differences were statistically significant.However,no significant differences could be found between the two groups in postoperative urinary leakage rate(RR=1.13,P=0.73).Conclusions RLP would be superior to PCNL for the treatment of solitary renal pelvic stone in increasing stonefree rate,reducing hospital stay,intraoperative blood loss,postoperative fever rate and transfusion rate.
作者
李秋伯
肖敏
何水映
Li Qiubo;Xiao Min;He Shuiying(Department of Urology,Jiulongpo Second People's Hospital,Chongqing 400052,China)
出处
《国际泌尿系统杂志》
2022年第1期1-6,共6页
International Journal of Urology and Nephrology
关键词
肾结石
肾造口术
经皮
腹腔镜检查
Kidney Calculi
Nephrostomy.Percutaneous
Laparoscopy
作者简介
通信作者:何水映,Email:heshuiying2008@163.com。
