経皮的腎砕石術における各種ガイド法の有効性と安全性:ネットワークメタアナリシス
Zhenkun Tan1,2, Yaqiong Wang2, Junjie Sun2
1Department of Urology, The First People's Hospital of Xiangtan City, Xiangtan, Hunan, China.
International journal of surgery (London, England)
|December 19, 2025
まとめ
造影超音波(CEUS)およびCT 3D画像再構成は、経皮的腎砕石術(PCNL)のガイドにおいて、優れた安全性と有効性を提供する。これらの所見を確認するには、さらなるランダム化比較試験が必要である。
科学分野:
- 泌尿器科学
- 医用画像処理
- 手術手技
背景:
- 経皮的腎砕石術(PCNL)は、成功のために正確な穿刺アクセスを必要とする。
- 様々なガイド法が存在し、それぞれに利点と欠点がある可能性がある。
主な方法:
- 系統的文献検索により、PCNLの透視、超音波(US)、透視+US、造影超音波(CEUS)、およびCT 3D画像再構成を比較したランダム化比較試験(RCT)を特定した。
- ネットワークメタアナリシスにより、結石除去、合併症、手術時間、在院日数、初回穿刺成功率、ヘモグロビン損失を比較した。
- バイアスリスクとエビデンスの確実性を評価した。
結論:
- CT 3D画像再構成およびCEUSは、安全性と有効性の点でPCNLにおける優れたガイド法である。
- これらの所見を確固たるものにし、臨床診療を導くためには、さらなるRCTが推奨される。
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