尿道透视和激光术用于下极石<2厘米,在位与位移? 一个系统的审查和元分析
Arran Dingwall1, James Leighton1, Angus Luk1
1Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK.
BJU international
|October 14, 2024
概括
在尿路透镜检查过程中将下极结石 (<2厘米) 移至上极,与现场治疗相比,显著增加了无结石率. 虽然手术时间略有增加,但并发症率仍然相似,这表明移位是一种有利的策略.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎石病的管理方法
- 最少侵入性的手术
背景情况:
- 较小于2厘米的下极结石会给治疗带来挑战.
- 带有激光的尿路透镜是常见的治疗方式.
- 最优的管理策略 (在现场与迁移) 仍在争论中.
研究的目的:
- 为了比较尿路透镜和激光术对下极结石 (<2厘米) 的有效性,在现场管理与向上极移动.
- 评估两种管理策略之间的无石头率 (SFR) 和并发症率.
- 评估操作时间和整体结果.
主要方法:
- 一个系统的审查和对发表到2023年3月之前的研究进行元分析.
- 包括患有下极结石<2厘米的成年患者.
- 使用R软件和"元包"进行手术结果和SFR在现场与移位石的比较分析.
主要成果:
- 包括5项研究 (2项追溯,3项随机试验) 涉及408名患者.
- 迁移策略导致SFR显著增加 (风险比1.21,P<0.001).
- 并发症发生率没有显著差异;移位组的手术时间略长 (平均差异5.62分钟,P=0.03).
结论:
- 较低杆石的移位 (<2厘米) 与现场处理相比,显著改善了无石的率.
- 与位移相关的经营时间增加可能没有临床意义.
- 这一元分析支持移位策略,以改善下极结石中的石头清除.
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