逆趋势在近端尿路结石管理中的位置:系统性审查和元分析
David Romeiro Victor1, Rafael de Albuquerque Pereira de Oliveira2, Adriana Gomes Pereira de Lucena2
1Faculty of Medical Sciences, Universidade de Pernambuco, Recife, Brazil.
The French journal of urology
|June 7, 2024
概括
在近距离尿管石的尿管透镜石 (URSL) 期间逆向Trendelenburg (RT) 定位可减少石头的反推力,并提高无石头率. 这种定位应该被认为是为了提高URSL的结果.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术创新 在外科创新.
- 医疗器械技术 医疗器械技术
背景情况:
- 尿道透镜石 (URSL) 是近端尿道结石的关键治疗方法.
- 在URSL过程中优化患者定位对于程序成功至关重要.
- 在URSL中反向Trendelenburg (RT) 位置的有效性仍然是研究领域.
研究的目的:
- 系统地审查和元分析RT位置与URSL中标准定位 (STD) 对近端尿路结石的有效性.
- 评估RT定位对石头反推力,无石头率,并发症和操作时间的影响.
主要方法:
- 在PubMed,Embase和Cochrane数据库中进行了全面的文献搜索.
- 包括的研究是随机对照试验和观察性研究,比较RT和STD位置.
- 数据分析使用了DerSimonian和Laird随机效应模型,使用Cochran的Q测试,I2统计数据和预测间隔评估异质性.
主要成果:
- 分析包括四项研究,共505名患者,58%接受了RT定位.
- RT定位与明显较低的石头反推力 (RR 0.42) 和较高的无石头率 (RR 1.33) 相关.
- 在RT和STD组之间,在整体并发症率或手术时间方面没有发现显著差异. 一个特定的20°RT角度显示了减少的反推力,没有异质性.
结论:
- 反向Trendelenburg定位在改善近端尿路结石患者的URSL关键结果方面表现出有效性.
- 这些发现支持考虑RT定位以提高URSL程序的有效性.
- 进一步的研究可能会探索最佳的RT角度和患者选择标准.
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