逆行肾内手术与经皮肾镜取石术治疗2～3 cm肾结石的meta分析

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Abstract Objective To systematically review the efficacy and safety of retrograde intrarenal surgery (RIRS) versus percutaneous nephrolithotomy (PCNL) in kidney stones of 2-3 cm. Methods PubMed, EMBASE, Science, WanFang, VIP and CNKI databases were electronically searched to identify all eligible comparative studies from inception of the database to October 2019. Then meta-analysis was performed by using RevMan 5.3 software. Results A total of 10 studies involving 1597 patients were included. Among them, there were 778 patients in the RIRS group and 819 patients in the PCNL group. The results of meta-analysis showed that: compared with PCNL, RIRS had lower stone-free rate (OR = 0.47, 95%CI [0.34, 0.66], P ＜ 0.000 01), shorter hospital stay (MD = -2.45, 95%CI[-2.96, -1.94], P ＜ 0.000 01), less decrease in haemoglobin (MD = -6.43, 95%CI[-9.05, -3.82], P ＜ 0.000 01), and lower complication rate (OR = 0.69, 95%CI [0.51, 0.93], P = 0.02), but no difference was found in operation time between the two groups (MD = 6.27, 95%CI[-3.51, 16.05], P = 0.21). Conclusion Compared with PCNL, RIRS has a lower SFR, but it has advantages in terms of hospital stay, decrease in haemoglobin, and complication rate. Therefore, for patients with kidney stones of 2-3 cm, RIRS is a safe and effective alternative to PCNL.

Key words： Renal stone Retrograde intrarenal surgery Percutaneous nephrolithotomy Meta-analysis

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	LI Jinze PENG Lei WEI Tangqiang XIA Zhongyou LI Yunxiang

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LI Jinze PENG Lei WEI Tangqiang XIA Zhongyou LI Yunxiang. Meta analysis of retrograde intrarenal surgery and percutaneous nephrolithotomy for the treatment of 2-3 cm renal calculi[J]. 中国医药导报, 2020, 17(27): 86-91.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I27/86

[1] Lotan Y，Buendia Jimenez I，Lenoir-Wijnkoop I，et al. Primary prevention of nephrolithiasis is cost-effective for a national healthcare system [J]. BJU Int，2012，110（11 Pt C）：E1060-E1067.
[2] Sorokin I，Mamoulakis C，Miyazawa K，et al. Epidemiology of stone disease across the world [J]. World J Urol，2017， 35（9）：1301-1320.
[3] Assimos D，Krambeck A，Miller NL，et al. Surgical Management of Stones：American Urological Association/Endourological Society Guideline，PART I [J]. J Urol，2016， 196（4）：1153-1160.
[4] Turk C，Petrik A，Sarica K，et al. EAU Guidelines on Interventional Treatment for Urolithiasis [J]. Eur Urol，2016， 69（3）：475-482.
[5] Wollin DA，Preminger GM. Percutaneous nephrolithotomy：complications and how to deal with them [J]. Urolithiasis，2018，46（1）：87-97.
[6] Desai J，Solanki R. Ultra-mini percutaneous nephrolithotomy（UMP）：one more armamentarium [J]. BJU Int，2013， 112（7）：1046-1049.
[7] Hennessey DB，Kinnear NK，Troy A，et al. Mini PCNL for renal calculi：does size matter? [J]. BJU Int，2017，119 Suppl 5：39-46.
[8] Grasso M，Ficazzola M. Retrograde ureteropyeloscopy for lower pole caliceal calculi [J]. J Urol，1999，162（6）：1904-1908.
[9] Riley JM，Stearman L，Troxel S. Retrograde ureteroscopy for renal stones larger than 2.5 cm [J]. J Endourol，2009，23（9）：1395-1398.
[10] Hyams ES，Munver R，Bird VG，et al. Flexible ureteror- enoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm：a multi-institutional experience [J]. J Endourol，2010，24（10）：1583-1588.
[11] Skolarikos A，Gross AJ，Krebs A，et al. Outcomes of Flexible Ureterorenoscopy for Solitary Renal Stones in the CROES URS Global Study [J]. J Urol，2015，194（1）：137-143.
[12] Pan J，Chen Q，Xue W，et al. RIRS versus mPCNL for single renal stone of 2-3 cm：clinical outcome and cost-effective analysis in Chinese medical setting [J]. Urolithiasis，2013，41（1）：73-78.
[13] Pieras E，Tubau V，Brugarolas X，et al. Comparative analysis between percutaneous nephrolithotomy and flexible ureteroscopy in kidney stones of 2-3 cm [J]. Actas Urol Esp，2017，41（3）：194-199.
[14] Chen HQ，Chen ZY，Zeng F，et al. Comparative study of the treatment of 20-30 mm renal stones with miniaturized percutaneous nephrolithotomy and flexible ureter-orenoscopy in obese patients [J]. World J Urol，2018，36（8）：1309-1314.
[15] Moher D，Liberati A，Tetzlaff J，et al. Preferred reporting items for systematic reviews and meta-analyses：the PRISMA statement [J]. BMJ，2009，339：b2535.
[16] Clark HD，Wells GA，Huet C，et al. Assessing the quality of randomized trials：reliability of the Jadad scale [J]. Control Clin Trials，1999，20（5）：448-452.
[17] Wells GA，Shea B，O’Connell D. The Newcastle-Ottawa Scale（NOS）for assessing the quality of nonrandomized studies in meta-analyses. Ottawa Hospital Research Institute Web site. http：//www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
[18] Wan X，Wang W，Liu J，et al. Estimating the sample mean and standard deviation from the sample size，median，range and/or interquartile range [J]. BMC Med Res Methodol，2014，14：135.
[19] 刘杰，白大应，石磊，等.输尿管软镜与微通道经皮肾镜治疗2～3 cm肾结石的对照研究[J].中华腔镜泌尿外科杂志：电子版，2018，12（6）：375-379.
[20] 梁福律，范先明，郭昭建，等.输尿管软镜碎石术与经皮肾镜取石术治疗2～2.5 cm肾下盏结石疗效对比[J].现代泌尿外科杂志，2015，20（7）：489-492.
[21] Zengin K，Tanik S，Karakoyunlu N，et al. Retrograde intrarenal surgery versus percutaneous lithotripsy to treat renal stones 2-3 cm in diameter [J]. Biomed Res Int，2015，2015：914231.
[22] Sari S，Ozok HU，Cakici MC，et al. A Comparison of Retrograde Intrarenal Surgery and Percutaneous Nephrolithotomy for Management of Renal Stones ?2 CM [J]. Urol J，2017，14（1）：2949-2954.
[23] Zhang Y，Wu Y，Li J，et al. Comparison of Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery for the Treatment of Lower Calyceal Calculi of 2-3 cm in Patients With Solitary Kidney [J]. Urology，2018，115：65-70.
[24] 李淦洪，李乾伟，杨俊，等.微创经皮肾镜与输尿管软镜处理直径2～3 cm肾结石的疗效及安全性分析[J].中国临床新医学，2019，12（5）：545-549.
[25] Zhao Z，Sun H，Zeng T，et al. An easy risk stratification to recommend the optimal patients with 2-3 cm kidney stones to receive retrograde intrarenal surgery or mini-percutaneous nephrolithotomy[J]. Urolithiasis，2020，48（2）：167-173.
[26] Palmero JL，Castello A，Miralles J，et al. Results of retrograde intrarenal surgery in the treatment of renal stones greater than 2 cm [J]. Actas Urol Esp，2014，38（4）：257-262.
[27] Kim TJ，Lee IJ，Lee JK，et al. Analysis of factors affecting re-admission after retrograde intrarenal surgery for renal stone [J]. World J Urol，2019，37（6）：1205-1210.
[28] Inoue T，Murota T，Okada S，et al. Influence of Pelvicaliceal Anatomy on Stone Clearance After Flexible Ureteroscopy and Holmium Laser Lithotripsy for Large Renal Stones [J]. J Endourol，2015，29（9）：998-1005.
[29] Sabnis RB，Jagtap J，Mishra S，et al. Treating renal calculi 1-2 cm in diameter with minipercutaneous or retrograde intrarenal surgery：a prospective comparative study [J]. BJU Int，2012，110（8 Pt B）：E346-E349.