通过皮肤进行的利切除术与对结石进行的逆行性内手术:一个柯克伦评论

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Leah Soderberg¹, Onuralp Ergun^2,3, Maylynn Ding⁴

¹Department of Hospital Internal Medicine, Mayo Clinic, Rochester, MN, USA.

BJU international

|November 9, 2023

概括

皮肤透神经切除术 (PCNL) 可能提供更好的无结石率,并减少重复手术相比逆行内手术 (RIRS) 的结石. 在这两种治疗方法之间,主要并发症的发生率似乎相似.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
最少侵入性的手术
腎石病的管理方法

背景情况:

结石 (结石) 影响了相当一部分人群.
穿皮神经利息切除术 (PCNL) 和逆行性内手术 (RIRS) 是常见的手术选择.
对PCNL与RIRS的有效性数据进行比较对于临床决策至关重要.

研究的目的:

为了比较PCNL与RIRS在成人结石治疗中的疗效和安全性.
评估结果,包括无石头率,主要并发症和需要二次干预的情况.

主要方法:

随机对照试验的系统审查和元分析.
在多个数据库中进行全面的文献搜索,直到2023年3月.
使用GRADE方法进行重复选,数据提取和偏差风险评估.

主要成果:

与RIRS相比,PCNL可能会提高无结石率 (SFR) (RR 1.13,95% CI 1.08-1.18;证据确定性低).
PCNL可能对严重并发症几乎没有影响 (RR 0.86,95% CI 0.59-1.25,证据的中等确定性).
PCNL可能会减少对二次干预的需要 (RR 0.31,95% CI 0.17-0.55;证据的低确定性).

结论:

PCNL在改善无结石率和减少对结石的二次干预方面展示了潜在的优势.
在PCNL和RIRS之间没有观察到重大并发症的显著差异.
研究结果支持对接受结石手术治疗的患者进行共享决策.

关键词:

结石是什么意思? 结石是什么意思?通过皮肤进行nephrolithotomy.逆行性内外科手术逆行性内外科石材处理石材处理尿路透镜检查尿路透镜检查

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