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Role of pre-operative ureteral stent on outcomes of retrograde intra-renal surgery (RIRS): systematic review and meta-analysis of 3831 patients and comparison of Asian and non-Asian cohorts.
Law, Y X T; Teoh, J Y C; Castellani, D; Lim, E J; Chan, E O T; Wroclawski, M; Pirola, G M; Giulioni, C; Rubilotta, E; Gubbioti, M; Scarcella, S; Chew, B H; Traxer, O; Somani, B K; Gauhar, V.
Afiliación
  • Law YXT; Department of Urology, National University Hospital, National University Health System, Singapore, Singapore. terencelaw83@gmail.com.
  • Teoh JYC; S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
  • Castellani D; Urology Division, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica Delle Marche, Ancona, Italy.
  • Lim EJ; Department of Urology, Singapore General Hospital, Singapore, Singapore.
  • Chan EOT; S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
  • Wroclawski M; Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil.
  • Pirola GM; BP-a Beneficência Portuguesa de São Paulo, São Paulo, Brazil.
  • Giulioni C; Department of Urology, San Donato Hospital, Arezzo, Italy.
  • Rubilotta E; Urology Division, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica Delle Marche, Ancona, Italy.
  • Gubbioti M; Department of Urology, A.O.U.I. Verona University, Verona, Italy.
  • Scarcella S; Department of Urology, San Donato Hospital, Arezzo, Italy.
  • Chew BH; Urology Division, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica Delle Marche, Ancona, Italy.
  • Traxer O; Department of Urologic Sciences, University of British Columbia, Vancouver, Canada.
  • Somani BK; Service d'Urologie, Sorbonne Université, Paris, France.
  • Gauhar V; Service d'Urologie, AP-HP, Hôpital Tenon, Paris, France.
World J Urol ; 40(6): 1377-1389, 2022 Jun.
Article en En | MEDLINE | ID: mdl-35072738
PURPOSE: To evaluate the outcomes of pre-stented (PS) versus non-pre-stented (NPS) patients who have undergone retrograde intrarenal surgery (RIRS) for renal calculi with subgroup analysis of Asian and non-Asian cohorts. METHODS: Protocol is registered in PROSPERO, CRD42021261123. Eligible studies identified from four electronic databases. Meta-analysis was done to enumerate the outcomes of RIRS in between PS and NPS. Secondary sub-analysis was done to look for differences in outcomes in Asian and non-Asian cohorts. RESULTS: Fourteen studies involving 3831 patients (4 prospective, 10 retrospective studies) were included. PS patients experienced higher success rates of ureteral access sheath (UAS) insertion than NPS (RR 1.09, 95% CI 1.05-1.13, p < 0.00001). PS patients had lower risk of ureteral injuries from UAS placement (RR 0.69, 95% CI 0.50-0.96, p = 0.03). No significant differences in intra- and postoperative complications between two groups were found. Stone-free rate (SFR) outcomes for residual fragment (RF) cut-off of < 1 mm and < 4 mm favoured the PS patients (RR 1.10, 95% CI 1.04-1.17, p = 0.002 for < 4 mm, RR1.10, 95% CI 1.02-1.19, p = 0.02 for < 1 mm). In the subgroup analysis, PS Asian patients had similar SFR as NPS patients for SFR(< 4 mm) but non-Asian population showed better outcomes in the PS patients for SFR(< 4 mm) (RR 1.31, 95% CI 1.13-1.52, p = 0.0005). CONCLUSIONS: This meta-analysis suggests that pre-stenting results in a higher success for UAS placement, minimising intraoperative ureteric injury, with higher overall SFR for any RF cut-off in PS cohorts. In non-Asian cohort, significant differences occurred at SFR < 4 mm but not for SFR < 1 mm. No difference was seen in our Asian cohort for any SFR cut-off in both PS and NPS patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Uréter / Cálculos Renales Tipo de estudio: Observational_studies / Risk_factors_studies / Systematic_reviews Límite: Humans Idioma: En Revista: World J Urol Año: 2022 Tipo del documento: Article País de afiliación: Singapur Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Uréter / Cálculos Renales Tipo de estudio: Observational_studies / Risk_factors_studies / Systematic_reviews Límite: Humans Idioma: En Revista: World J Urol Año: 2022 Tipo del documento: Article País de afiliación: Singapur Pais de publicación: Alemania