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Urolithiasis

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01.12.2023 | Research

Determining the safety and effectiveness of percutaneous nephrolithotomy and retrograde intrarenal surgery in treating nephrolithiasis in patients with solitary kidneys

verfasst von: Lei Peng, Chunyang Meng, Zhongyou Xia, Rui Liang, Lijian Gan, Kangsen Li, Dehong Cao, Yunxiang Li

Erschienen in: Urolithiasis | Ausgabe 1/2023

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Abstract

We performed a meta-analysis to compare the safety and effectiveness of percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) in treating nephrolithiasis ≥ 2 cm in patients with solitary kidneys. This systematic review was registered on PROSPERO (registration ID: CRD42021270519). The search time was set from the establishment of the databases until April 30, 2021. A systematic search was performed in the PubMed, MEDLINE, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), Cochrane Library, and Embase databases. Stata 16 was used to perform the statistical analysis of the extracted data. After screening using strict inclusion and exclusion criteria, five studies with a total of 474 patients were included in the final meta-analysis. According to the literature quality assessment scale statistics, the five studies included were of high quality. The results of the meta-analysis showed that RIRS had lesser hemoglobin loss (HL), shorter length of hospital stay (LOS), lower initial (OR = 3.39, 95% CI [1.97, 5.83], P = 0.02) and final stone-free rates (OR = 2.24, 95% CI [1.24, 4.06], P = 0.03), but a higher incidence of grade III-IV complications (OR = 0.29, 95% CI [0.08, 0.97], P = 0.04) than PCNL. The difference between the two surgical methods was not statistically significant in terms of operation time (OT), grade I–II complication rate, and total complication rate. For nephrolithiasis ≥ 2 cm in patients with a solitary kidney, RIRS has the advantage of less HL and shorter LOS, while PCNL benefits from its higher SFR (both initial and final). Both RIRS and PCNL are effective treatments for nephrolithiasis in patients with a solitary kidney, and clinicians should choose the most appropriate option to achieve the best treatment outcome, taking into account the patient's underlying conditions and medical conditions.

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Titel: Determining the safety and effectiveness of percutaneous nephrolithotomy and retrograde intrarenal surgery in treating nephrolithiasis in patients with solitary kidneys
verfasst von: Lei Peng
Chunyang Meng
Zhongyou Xia
Rui Liang
Lijian Gan
Kangsen Li
Dehong Cao
Yunxiang Li
Publikationsdatum: 01.12.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Urolithiasis / Ausgabe 1/2023
Print ISSN: 2194-7228
Elektronische ISSN: 2194-7236
DOI: https://doi.org/10.1007/s00240-022-01386-3

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