[A meta-analysis of tubeless versus standard percutaneous nephrostolithotomy]

To systematically review the advantages of tubeless percutaneous nephrolithotomy.

The randomized controlled trials (RCTs) of tubeless and standard percutaneous nephrolithotomy were retrieved and their included references investigated. Data analyses of literatures fulfilling the inclusion criteria were performed with the Cochrane ColLaboration's RevMan 5.0 software.

Seven literatures were finally retrieved after screening. A total of 1365 patients were included for a meta-analysis. The results showed that, as compared with the control group (standard percutaneous nephrolithotomy), the patients in the trial group (tubeless percutaneous nephrolithotomy) had the following features. (1) There was no significant difference in mean operative duration and change of hemoglobin (95%CI -15.16 to 0.13, P = 0.05; 95%CI -0.16 to 0.19, P = 0.90 respectively). (2) The hospitalization stay was shortened an average of 23.86 hours (95%CI -32.35 to -15.36, P = 0.000). (3) The postoperative analgesic dose was lowered by 69.02 mg (95%CI -107.67 to -30.36, P = 0.000). (4) There was a remarkable improvement of the stone-free rate (95%CI 1.25 to 2.95, P = 0.003).

Tubeless percutaneous nephrolithotomy may shorten the hospitalization stay, lower the postoperative analgesic dose and improve the stone-free rate. It is significantly superior to standard percutaneous nephrolithotomy.