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A meta-analysis: retrograde intrarenal surgery vs. percutaneous nephrolithotomy in children

BACKGROUNDS: The increasing prevalence of pediatric kidney stones worldwide makes minimally invasive lithotripsy like retrograde intrarenal surgery (RIRS) and percutaneous Nephrolithotomy (PCNL) more prevalent. However, their safety and efficacy are controversial. Consequently, a meta-analysis of th...

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Autores principales: Yuan, Yi, Liang, Yan-nei, Li, Kai-feng, Ho, Yi-ru, Wu, Qian-long, Zhao, Zhang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10185757/
https://www.ncbi.nlm.nih.gov/pubmed/37205217
http://dx.doi.org/10.3389/fped.2023.1086345
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author Yuan, Yi
Liang, Yan-nei
Li, Kai-feng
Ho, Yi-ru
Wu, Qian-long
Zhao, Zhang
author_facet Yuan, Yi
Liang, Yan-nei
Li, Kai-feng
Ho, Yi-ru
Wu, Qian-long
Zhao, Zhang
author_sort Yuan, Yi
collection PubMed
description BACKGROUNDS: The increasing prevalence of pediatric kidney stones worldwide makes minimally invasive lithotripsy like retrograde intrarenal surgery (RIRS) and percutaneous Nephrolithotomy (PCNL) more prevalent. However, their safety and efficacy are controversial. Consequently, a meta-analysis of the comparison between RIRS and PCNL is conducted. METHODS: Clinical trials were selected from PubMed, EMBASE, Scopus, and Cochrane Library databases. The data extraction and study quality assessment were performed by two individuals independently. The data relating to therapeutic effects were extracted and analyzed by Review manager 5.4. RESULTS: Thirteen studies involving 1,019 patients were included. The micro-PCNL excelled in stone-free rate (P = 0.003), postoperative fever rate (P = 0.02), and Clavien–Dindo II complications (P = 0.05). Notably, the mean age of the micro-PCNL group was younger than other groups (P = 0.0005). The operation time in mini-PCNL was longer than RIRS (P < 0.00001) but with high heterogeneity (I(2) = 99%). There was no difference in Clavien–Dindo I, II, and III complications between the PCNL and the RIRS, but mini-PCNL showed a higher probability than RIRS in Clavien–Dindo I (P = 0.0008) and II complications (P = 0.007). CONCLUSIONS: Compared with RIRS, micro-PCNL could be a better therapeutic option for kidney stones in children. Of note, more parameters should be analyzed to illustrate the efficacy of different minimally invasive surgeries for pediatric kidney stones due to poor cases in our study. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/#recordDetails, PROSPERO CRD42022323611
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spelling pubmed-101857572023-05-17 A meta-analysis: retrograde intrarenal surgery vs. percutaneous nephrolithotomy in children Yuan, Yi Liang, Yan-nei Li, Kai-feng Ho, Yi-ru Wu, Qian-long Zhao, Zhang Front Pediatr Pediatrics BACKGROUNDS: The increasing prevalence of pediatric kidney stones worldwide makes minimally invasive lithotripsy like retrograde intrarenal surgery (RIRS) and percutaneous Nephrolithotomy (PCNL) more prevalent. However, their safety and efficacy are controversial. Consequently, a meta-analysis of the comparison between RIRS and PCNL is conducted. METHODS: Clinical trials were selected from PubMed, EMBASE, Scopus, and Cochrane Library databases. The data extraction and study quality assessment were performed by two individuals independently. The data relating to therapeutic effects were extracted and analyzed by Review manager 5.4. RESULTS: Thirteen studies involving 1,019 patients were included. The micro-PCNL excelled in stone-free rate (P = 0.003), postoperative fever rate (P = 0.02), and Clavien–Dindo II complications (P = 0.05). Notably, the mean age of the micro-PCNL group was younger than other groups (P = 0.0005). The operation time in mini-PCNL was longer than RIRS (P < 0.00001) but with high heterogeneity (I(2) = 99%). There was no difference in Clavien–Dindo I, II, and III complications between the PCNL and the RIRS, but mini-PCNL showed a higher probability than RIRS in Clavien–Dindo I (P = 0.0008) and II complications (P = 0.007). CONCLUSIONS: Compared with RIRS, micro-PCNL could be a better therapeutic option for kidney stones in children. Of note, more parameters should be analyzed to illustrate the efficacy of different minimally invasive surgeries for pediatric kidney stones due to poor cases in our study. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/#recordDetails, PROSPERO CRD42022323611 Frontiers Media S.A. 2023-05-02 /pmc/articles/PMC10185757/ /pubmed/37205217 http://dx.doi.org/10.3389/fped.2023.1086345 Text en © 2023 Yuan, Liang, Li, Ho, Wu and Zhao. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Yuan, Yi
Liang, Yan-nei
Li, Kai-feng
Ho, Yi-ru
Wu, Qian-long
Zhao, Zhang
A meta-analysis: retrograde intrarenal surgery vs. percutaneous nephrolithotomy in children
title A meta-analysis: retrograde intrarenal surgery vs. percutaneous nephrolithotomy in children
title_full A meta-analysis: retrograde intrarenal surgery vs. percutaneous nephrolithotomy in children
title_fullStr A meta-analysis: retrograde intrarenal surgery vs. percutaneous nephrolithotomy in children
title_full_unstemmed A meta-analysis: retrograde intrarenal surgery vs. percutaneous nephrolithotomy in children
title_short A meta-analysis: retrograde intrarenal surgery vs. percutaneous nephrolithotomy in children
title_sort meta-analysis: retrograde intrarenal surgery vs. percutaneous nephrolithotomy in children
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10185757/
https://www.ncbi.nlm.nih.gov/pubmed/37205217
http://dx.doi.org/10.3389/fped.2023.1086345
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