OBJECTIVES: To assess the efficacy and safety of tubeless percutaneous nephrolithotomy (PCNL) compared with standard or small-bore PCNL with a meta-analysis of randomized, controlled trials. METHODS: All eligible studies were searched on MEDLINE, Embase, and the Cochrane Library databases. Risk ratio (RR), mean difference, or standardized mean difference (SMD), with its 95% CI, was used to evaluate the size effect. RESULTS: Ten and 3 trials were identified for comparison I (tubeless PCNL vs standard PCNL, 320 cases and 323 controls) and comparison II (tubeless PCNL vs small-bore PCNL, 55 cases and 54 controls), respectively. Tubeless PCNL required significantly less analgesia relative to standard PCNL (SMD -1.72; 95% CI -2.30 to 1.13; P(heterogeneity) = 0.04) and small-pore PCNL (SMD -0.69; 95% CI -1.13 to 2.05; P(heterogeneity) = 0.94). Furthermore, there was a remarkably shorter hospital stay in comparison I (SMD -1.35; 95% CI -1.40 to 1.30; P(heterogeneity) = 0.60) and comparison II (SMD -0.49; 95% CI -0.76 to 0.21; P(heterogeneity) = 0.15). The return to normal activity days was also significantly decreased in comparison I (SMD -4.34; 95% CI -6.28 to 2.41; P(heterogeneity) = 0.02). However, no significant difference was observed in the analyses concerning stone-free blood transfusion and complications rate in both comparisons. In subgroup analyses by nephrostomy diameter (22-Fr) and drainage methods, most results were consistent with the overall findings except for that to evaluate the operative time in the double-J stent subgroup. CONCLUSIONS: Tubeless PCNL is associated with less pain and quicker recovery compared with standard or small-bore PCNL, in the management of uncomplicated renal calculi.
OBJECTIVES: To assess the efficacy and safety of tubeless percutaneous nephrolithotomy (PCNL) compared with standard or small-bore PCNL with a meta-analysis of randomized, controlled trials. METHODS: All eligible studies were searched on MEDLINE, Embase, and the Cochrane Library databases. Risk ratio (RR), mean difference, or standardized mean difference (SMD), with its 95% CI, was used to evaluate the size effect. RESULTS: Ten and 3 trials were identified for comparison I (tubeless PCNL vs standard PCNL, 320 cases and 323 controls) and comparison II (tubeless PCNL vs small-bore PCNL, 55 cases and 54 controls), respectively. Tubeless PCNL required significantly less analgesia relative to standard PCNL (SMD -1.72; 95% CI -2.30 to 1.13; P(heterogeneity) = 0.04) and small-pore PCNL (SMD -0.69; 95% CI -1.13 to 2.05; P(heterogeneity) = 0.94). Furthermore, there was a remarkably shorter hospital stay in comparison I (SMD -1.35; 95% CI -1.40 to 1.30; P(heterogeneity) = 0.60) and comparison II (SMD -0.49; 95% CI -0.76 to 0.21; P(heterogeneity) = 0.15). The return to normal activity days was also significantly decreased in comparison I (SMD -4.34; 95% CI -6.28 to 2.41; P(heterogeneity) = 0.02). However, no significant difference was observed in the analyses concerning stone-free blood transfusion and complications rate in both comparisons. In subgroup analyses by nephrostomy diameter (22-Fr) and drainage methods, most results were consistent with the overall findings except for that to evaluate the operative time in the double-J stent subgroup. CONCLUSIONS: Tubeless PCNL is associated with less pain and quicker recovery compared with standard or small-bore PCNL, in the management of uncomplicated renal calculi.
Authors: Alejandro Mercado; Mario I Fernández; Pedro Recabal; Daniela Fleck; Rodrigo Ledezma; Francisco Moya; Francisco Sepúlveda; Roberto Vilches; Diego Reyes; Fernando Marchant Journal: Urolithiasis Date: 2013-03-23 Impact factor: 3.436
Authors: Marco Garofalo; Cristian Vincenzo Pultrone; Riccardo Schiavina; Eugenio Brunocilla; Francesco Sanguedolce; Marco Borghesi; Christian Rocca; Chiara Del Prete; Antonio Maria Morselli-Labate; Alexandro Paccapelo; Giuseppe Martorana Journal: Urolithiasis Date: 2013-04-30 Impact factor: 3.436
Authors: Luigi Cormio; Glenn Preminger; Christian Saussine; Niels Peter Buchholz; Xiaochun Zhang; Helena Walfridsson; Andreas J Gross; Jean de la Rosette Journal: World J Urol Date: 2012-10-17 Impact factor: 4.226