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Systematic review and meta-analysis to compare success rates of retrograde intrarenal surgery versus percutaneous nephrolithotomy for renal stones >2 cm: An update.

Authors
 Sung Ku Kang  ;  Kang Su Cho  ;  Dong Hyuk Kang  ;  Hae Do Jung  ;  Jong Kyou Kwon  ;  Joo Yong Lee 
Citation
 Medicine, Vol.96(49) : e9119, 2017 
Journal Title
 Medicine 
ISSN
 0025-7974 
Issue Date
2017
MeSH
Humans ; Kidney Calculi/surgery ; Nephrolithotomy, Percutaneous/methods ; Randomized Controlled Trials as Topic ; Urologic Surgical Procedures/methods
Abstract
BACKGROUND: We performed a systematic review and meta-analysis comparing stone-free rates between retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL), using updated, more reliable evidence. MATERIALS AND METHODS: Randomized controlled trials comparing RIRS and PCNL for >2 cm stones were identified from electronic databases. Stone-free rates for the procedures were compared by qualitative and quantitative syntheses (meta-analyses). Outcome variables are shown as risk ratios (RRs) with 95% confidence intervals (CIs). RESULTS: Eleven articles were included in this study. Most recently published studies exhibited relatively low quality during quality assessment. For the meta-analysis comparing success (stone-free) rates between PCNL and RIRS, the forest plot using the random-effects model showed an RR of 1.11 (95% CI 1.02-1.21, P < .014) favoring PCNL. After determining the among-study heterogeneity, subgroup analysis was performed of 9 studies with less heterogeneity: the stone-free rate of PCNL was superior to that of RIRS using a fixed-effect model (RR 1.07, 95% CI 1.01-1.14, P < .019) for these studies. CONCLUSIONS: RIRS can be a safe and effective procedure for selected patients with large renal stones. However, in this meta-analysis, the postoperative stone-free rate of PCNL was higher than that of RIRS in patients with >2 cm renal stones.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161488
DOI
10.1097/MD.0000000000009119
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실)
Yonsei Authors
강승구(Kang, Sung Ku) ; 이주용(Lee, Joo Yong) ; 정해도(Jung, Hae Do) ; 조강수(Cho, Kang Su)
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