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Does displacement of lower pole stones during retrograde intrarenal surgery improves stone-free status? A systematic review and meta-analysis
PURPOSE: Kidney stones are one of the most common urological diseases worldwide. The size and location of the stone are the most important factors in determining the most suitable treatment options. The aim of this review was to evaluate the displacement of lower pole stones. METHODS: Three studies...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691198/ http://dx.doi.org/10.1590/acb386623 |
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author | Santana, Roberto Nogueira Porto, Breno Cordeiro Passerotti, Carlo Camargo Artifon, Everson Luiz de Almeida Otoch, José Pinhata da Cruz, José Arnaldo Shiomi |
author_facet | Santana, Roberto Nogueira Porto, Breno Cordeiro Passerotti, Carlo Camargo Artifon, Everson Luiz de Almeida Otoch, José Pinhata da Cruz, José Arnaldo Shiomi |
author_sort | Santana, Roberto Nogueira |
collection | PubMed |
description | PURPOSE: Kidney stones are one of the most common urological diseases worldwide. The size and location of the stone are the most important factors in determining the most suitable treatment options. The aim of this review was to evaluate the displacement of lower pole stones. METHODS: Three studies assessing the efficacy of translocating kidney stones from the lower pole of the kidney to other locations during retrograde intrarenal surgery published in the last 20 years were included. A systematic search was conducted in the PubMed, Embase, Latin American and Caribbean Health Sciences Literature (LILACS), and Web of Science databases using the following search terms: “Lower pole,” “Lithotripsy.” Meta-analysis was performed using Review Manager version 5.4. RESULTS: Stone-free rates were improved through displacement (odds ratio – OR = -0.15; 95% confidence interval–95%CI -0.24–-0.05; p = 0.002; I2 = 21%), but at the cost of increased surgical duration (mean difference = -12.50; 95%CI -24.06–-0.95; p = 0.03; I2 = 94%). Although this represents a potentially negative outcome, the improvement in clearance rates justifies the additional investment of time and effort. CONCLUSIONS: Displacement of lower pole kidney stones for subsequent lithotripsy brings significant benefits in terms of stone-free rate, with no difference in laser energy usage. However, it results in increased surgical time. Despite these factors, the benefits to patients undergoing the procedure are substantial. |
format | Online Article Text |
id | pubmed-10691198 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia |
record_format | MEDLINE/PubMed |
spelling | pubmed-106911982023-12-02 Does displacement of lower pole stones during retrograde intrarenal surgery improves stone-free status? A systematic review and meta-analysis Santana, Roberto Nogueira Porto, Breno Cordeiro Passerotti, Carlo Camargo Artifon, Everson Luiz de Almeida Otoch, José Pinhata da Cruz, José Arnaldo Shiomi Acta Cir Bras Review Article PURPOSE: Kidney stones are one of the most common urological diseases worldwide. The size and location of the stone are the most important factors in determining the most suitable treatment options. The aim of this review was to evaluate the displacement of lower pole stones. METHODS: Three studies assessing the efficacy of translocating kidney stones from the lower pole of the kidney to other locations during retrograde intrarenal surgery published in the last 20 years were included. A systematic search was conducted in the PubMed, Embase, Latin American and Caribbean Health Sciences Literature (LILACS), and Web of Science databases using the following search terms: “Lower pole,” “Lithotripsy.” Meta-analysis was performed using Review Manager version 5.4. RESULTS: Stone-free rates were improved through displacement (odds ratio – OR = -0.15; 95% confidence interval–95%CI -0.24–-0.05; p = 0.002; I2 = 21%), but at the cost of increased surgical duration (mean difference = -12.50; 95%CI -24.06–-0.95; p = 0.03; I2 = 94%). Although this represents a potentially negative outcome, the improvement in clearance rates justifies the additional investment of time and effort. CONCLUSIONS: Displacement of lower pole kidney stones for subsequent lithotripsy brings significant benefits in terms of stone-free rate, with no difference in laser energy usage. However, it results in increased surgical time. Despite these factors, the benefits to patients undergoing the procedure are substantial. Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia 2023-12-01 /pmc/articles/PMC10691198/ http://dx.doi.org/10.1590/acb386623 Text en https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Santana, Roberto Nogueira Porto, Breno Cordeiro Passerotti, Carlo Camargo Artifon, Everson Luiz de Almeida Otoch, José Pinhata da Cruz, José Arnaldo Shiomi Does displacement of lower pole stones during retrograde intrarenal surgery improves stone-free status? A systematic review and meta-analysis |
title | Does displacement of lower pole stones during retrograde intrarenal surgery improves stone-free status? A systematic review and meta-analysis |
title_full | Does displacement of lower pole stones during retrograde intrarenal surgery improves stone-free status? A systematic review and meta-analysis |
title_fullStr | Does displacement of lower pole stones during retrograde intrarenal surgery improves stone-free status? A systematic review and meta-analysis |
title_full_unstemmed | Does displacement of lower pole stones during retrograde intrarenal surgery improves stone-free status? A systematic review and meta-analysis |
title_short | Does displacement of lower pole stones during retrograde intrarenal surgery improves stone-free status? A systematic review and meta-analysis |
title_sort | does displacement of lower pole stones during retrograde intrarenal surgery improves stone-free status? a systematic review and meta-analysis |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691198/ http://dx.doi.org/10.1590/acb386623 |
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