📃 Paper Title: Percutaneous nephrolithotomy versus retrograde intrarenal surgery: a systematic review and meta-analysis
🧍 Author: Shuba De
🕒 Year: 2014
📚 Journal: European Urology
🌎 Country: USA
ㅤContext to the study:
Can you cite a meta-analysis comparing the efficacy of Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery for the management of kidney stones?
ㅤ✅ Take-home message of study:
Percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for kidney stones are associated with different efficacy and complication profiles. The type of treatment should be tailored based on the patient's and the stone's features.
ㅤ Systematic review and meta-analysis
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Study participants:
Two randomised and eight non-randomised studies were analysed. A total of 727 (62%) patients received PCNL and 454 (38%) RIRS. Treatment comprised RIRS, standard PCNL, mini-PCNL and micro-PCNL.
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Key study outcomes:
No difference between PCNL and RIRS in terms of operative time. PCNL provided a significantly higher stone-free rate (p<0.001), higher complication rates (p<0.001), and a larger decrease in haemoglobin (p<0.001). RIRS led to a shorter hospital stay (p<0.001).
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Study Limitations:
Heterogeneity across studies: different inclusion and exclusion criteria, several techniques analyzed, indications for RIRS and PCNL were often different. Most studies were non-randomized. The meta-analysis included only two randomized control trials of moderate quality. Retreatment rates and the need for auxiliary procedures were not included in the meta-analysis.
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