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首页> 外文期刊>Journal of endourology >Retrograde Intrarenal Surgery Versus Percutaneous Nephrolithotomy Versus Extracorporeal Shockwave Lithotripsy for Treatment of Lower Pole Renal Stones: A Meta-Analysis and Systematic Review
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Retrograde Intrarenal Surgery Versus Percutaneous Nephrolithotomy Versus Extracorporeal Shockwave Lithotripsy for Treatment of Lower Pole Renal Stones: A Meta-Analysis and Systematic Review

机译：逆行肾内手术与经皮肾镜取石术与体外冲击波碎石术治疗下极肾结石：荟萃分析和系统评价。

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Background and Purpose: The optimal treatment of patients with lower pole renal stones continues to be a dilemma for urologists. Retrograde intrarenal surgery (RIRS), percutaneous nephrolithotomy (PCNL), and extracorporeal shockwave lithotripsy (SWL) all constitute viable therapeutic options in selected patients. The aim of this study was to assess the efficacy and safety of RIRS, PCNL, and SWL in management of lower pole renal stones. Methods: A literature search was performed in July 2014 using PubMed, Embase, and Web of Science databases. Literature reviewed included meta-analysis and randomized and nonrandomized controlled studies to identify relevant studies for the meta-analysis. Results: Six randomized and eight nonrandomized studies were identified for analysis. PCNL provided a significantly higher stone-free rate (SFR) compared with RIRS and SWL. Furthermore, no statistical significant difference was found when PCNL was compared with RIRS and SWL for complication rate. Compared with the other two treatments, RIRS had a longer operative time and PCNL had a longer hospital stay. SWL was associated with significantly higher re-treatment rate compared with RIRS and PCNL, whereas there were no significant differences in auxiliary procedure rates among the three treatment techniques. Conclusion: RIRS offers a relative higher SFR while it has a longer operative time. PCNL is associated with the highest SFR at the expense of the longest hospital stay. SWL is performed as an outpatient procedure with a relative shorter operative time; however, it has lower a SFR and higher re-treatment rate. The categories of complications vary while the overall complication rates are comparable among the three treatment techniques.
机译：背景与目的：下极肾结石患者的最佳治疗仍然是泌尿科医师的难题。肾内逆行手术（RIRS），经皮肾镜取石术（PCNL）和体外冲击波碎石术（SWL）在选定的患者中均构成可行的治疗选择。这项研究的目的是评估RIRS，PCNL和SWL在治疗下极肾结石中的有效性和安全性。方法：2014年7月使用PubMed，Embase和Web of Science数据库进行文献检索。所审查的文献包括荟萃分析以及随机和非随机对照研究，以确定与荟萃分析相关的研究。结果：确定了六项随机研究和八项非随机研究进行分析。与RIRS和SWL相比，PCNL提供了更高的无石率（SFR）。此外，将PCNL与RIRS和SWL的并发症发生率进行比较时，没有发现统计学上的显着差异。与其他两种治疗相比，RIRS的手术时间更长，PCNL的住院时间更长。与RIRS和PCNL相比，SWL与更高的再治疗率相关，而三种治疗技术之间的辅助手术率没有显着差异。结论：RIRS具有相对较高的SFR，但手术时间更长。 PCNL与最高SFR相关，但要花费最长的住院时间。 SWL作为门诊手术进行，手术时间相对较短;但是，它的SFR较低，再处理率较高。在三种治疗技术中，并发症的类别各不相同，而总体并发症发生率却相当。

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