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Systematic Review and Meta-Analysis of Nephrostomy Placement Versus Tubeless Percutaneous Nephrolithotomy.
Borges, Claudio F; Fregonesi, Adriano; Silva, Daniel Carlos; Sasse, André Deeke.
Afiliación
  • Borges CF; Department of Urology, Hospital das Clínicas, State University of Campinas-UNICAMP , Campinas, São Paulo, Brazil .
J Endourol ; 2010 Oct 19.
Article en En | MEDLINE | ID: mdl-20958141
Abstract Purpose: We performed a systemic review with meta-analysis to compare tubeless vs conventional percutaneous nephrolithotomy (PCNL) and assess the effectiveness and safety of this innovative procedure. Materials and Methods: A systematic review of PUBMED, EMBASE, LILACS, and Cochrane Library was performed to identify all randomized controlled trials (RCTs) that compared tubeless PCNL vs conventional PCNL. The analyzed outcomes were stone-free rate, pain assessment, analgesic medication requirements, operative time, hospitalization time, blood loss, and complications. Results: A total of 10 RCTs were identified that reported 621 patients. Seven studies analyzed stone-free rates. Meta-analysis of the data resulted in no difference between tubeless and conventional PCNL. Operative time, blood transfusion, hemoglobin drop and postoperative fever did not differ between the groups. Meta-analysis of length of hospitalization and prolonged urinary drainage was analyzed and favored the tubeless PCNL group. Conclusions: Tubeless PCNL is a safe and effective procedure with a stone clearance rate comparable to that of conventional PCNL. Tubeless PCNL presented a shorter hospital stay and less postoperative urinary leakage. Pain reduction and minimization of analgesic requirements also were demonstrated.
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Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Systematic_reviews Idioma: En Revista: J Endourol Asunto de la revista: UROLOGIA Año: 2010 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Systematic_reviews Idioma: En Revista: J Endourol Asunto de la revista: UROLOGIA Año: 2010 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos