输尿管软镜与经皮肾镜取石术治疗儿童肾结石疗效和安全性的Meta分析

Clinical efficacy and safety of flexible ureteroscope lithotripsy versus percutaneous nephrolithotomy for pediatric renal stones: a Meta-analysis

摘要:

摘要：目的??比较输尿管软镜碎石术（FURL）与经皮肾镜取石术（PCNL）治疗儿童肾结石的疗效和安全性。方法 检索2014年6月30日－2019年6月30日的文献，使用Review Manager 5.2进行数据分析。结果 共纳入7篇研究，FURL治疗组220例，PCNL治疗组250例。Meta分析结果显示，两组结石清除率[OR?=?0.72，95%CI（0.43，1.23）]、手术时间[MD?=?-6.43，95%CI（-23.79，10.93）]、并发症发生率[OR?=?0.84，95%CI（0.39，1.78）]、血红蛋白下降值[MD?=?-3.64，95%CI（-7.21，-0.07）]比较，差异均无统计学意义；FURL治疗组较PCNL治疗组DJ管留置率更高[OR?=?13.93，95%CI（2.09，92.93）]，但住院时间[MD?=?-0.92，95%CI（-1.70，-0.14）]和透视时间更短[MD?=?-69.23，95%CI（-87.06，-51.40）]。结论 输尿管软镜可能是一种比PCNL更具优势的手术方式，但儿童肾结石的大小及肾盏分布位置对不同手术方式疗效的影响暂不清楚，仍需不断探讨儿童肾结石治疗方式的合适选择。

Abstract:

Abstract: Objective?To compare the efficacy and safety of flexible ureteroscope lithotripsy (FURL) versus percutaneous nephrolithotomy (PCNL) for pediatric renal stones.?Methods?To search the literature from June 30, 2014 to June 30, 2019. Data analysis was conducted by Review Manager 5.2 software.?Results?Data from seven studies (220 cases in FURL group, 250 cases in PCNL group) were analyzed. There was no significant difference between the two groups in stone-free rate (OR?=?0.72, 95%CI: 0.43 to 1.23), operation time (MD?=?-6.43, 95%CI: -23.79 to 10.93), complication rate(OR?=?0.84, 95%CI: 0.39 to 1.78), hemoglobin deficit (MD?= -3.64, 95%CI: -7.21 to -0.07). FURL group had higher Double-J stent insertion rate (OR?=?13.93, 95%CI: 2.09 to 92.93), shorter hospital stays (MD?=?-0.92, 95% CI: -1.70 to -0.14), shorter fluoroscopy time (MD?=?-69.23, 95%CI: -87.06 to -51.40) than that in PCNL group.?Conclusion?Flexible ureteroscope lithotripsy may be a more advantageous operation method than percutaneous nephrolithotomy for renal stones in children. However, the effect of the size and distribution of children’s renal stones on the efficacy of different surgical methods is not clear now, it is still necessary to explore the appropriate treatment methods for children’s renal stones.