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Title: Miniaturised percutaneous nephrolithotomy versus flexible ureteropyeloscopy: a systematic review and meta-analysis comparing clinical efficacy and safety profile.
Austin Authors: Davis, Niall F;Quinlan, Mark R;Poyet, C;Lawrentschuk, Nathan;Bolton, Damien M ;Webb, D;Jack, Gregory S 
Affiliation: Department of Urology, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 16-Feb-2018
Date: 2018-02-16
Publication information: World Journal of Urology 2018; 36(7): 1127-1138
Abstract: This study aims to comparatively evaluate clinical outcomes of mini-PCNL and FURS for treating urinary tract calculi in a single session. A systematic search using electronic databases was performed for studies comparing mini-PCNL and FURS for the treatment of urinary tract calculi. The primary outcome measurements were stone-free rates (SFRs) and complication rates for both techniques. Secondary outcome measurements were to compare patient demographics, operative duration, and inpatient stay. Meta-analysis was performed with Review Manager version 5.3 software. Sixteen studies on 1598 patients (n = 877 for mini-PCNL and n = 721 for FURS) met inclusion criteria. Demographics including age (p = 0.26), body mass index (BMI) (p = 0.51), and gender ratio (p = 0.6), were similar in both groups. Overall, SFR was significantly greater in the mini-PCNL group compared to the FURS group (n = 763/877, 89.3 ± 8.4% versus n = 559/721, 80.1 ± 13.3% [OR 2.01; 95% CI 1.53-2.64; p < 0.01]). Duration of inpatient stay was significantly greater in the mini-PCNL group compared to the FURS group (n = 877, 4 ± 1.6 days versus n = 721, 2.5 ± 2.2 days, respectively [WMD: 1.77; 95% CI 1.16-2.38, p < 0.01]. Overall complication rates were not significantly different between mini-PCNL and FURS (n = 171/877, 19.5 ± 19.1% versus n = 112/721, 15.5 ± 18.9%, respectively [OR 1.43; 95% CI 0.85-2.4, p = 0.18]). Mini-PCNL is associated with greater SFRs and longer inpatient stay compared to FURS. Complication rates were similar for both techniques. The advantages and disadvantages of both technologies should be familiar to urologists and conveyed to patients prior to urological intervention for nephrolithiasis.
DOI: 10.1007/s00345-018-2230-x
ORCID: 0000-0002-5145-6783
Journal: World Journal of Urology
PubMed URL: 29450733
Type: Journal Article
Subjects: Flexible pyeloscopy
Flexible ureteropyeloscopy
Flexible ureteroscopy
Miniaturised percutaneous nephrolithotomy
Percutaneous nephrolithotomy
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