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对比门诊和住院的皮肤穿神经切除术:系统性审查和元分析

Katie Du¹, Michael Uy², Alan Cheng³

¹Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.

BJU international

|December 5, 2024

概括

门诊性皮肤穿神经切除术 (PCNL) 是安全有效的选择患者,显示较少的整体并发症和更高的无结石率. 同一天放弃 (SDD) 并没有显著改变结果,支持当前的选择标准.

科学领域:

腎臟病學 (nephrology) 是一種醫學專業.
泌尿器科泌尿器科泌尿器科泌尿器科
外科手术的结果

背景情况:

穿皮骨切除术 (PCNL) 是对结石的一种常见手术.
对于各种外科手术,越来越多地探索出门护理模式.
了解门诊PCNL的安全性和有效性对于患者选择和医疗保健经济学至关重要.

研究的目的:

为了比较住院患者和门诊外皮瘤切除术 (PCNL) 的术前特征和术后结果.
在门诊PCNL队列中对同一天出院 (SDD) 患者进行子组分析.
总结已发表的门诊PCNL途径,并比较相关成本和患者满意度.

主要方法:

一个系统的审查和元分析,遵循PRISMA指南.
包括25项研究,并对12项比较研究进行了元分析.
门诊PCNL的定义是23小时内出院,SDD是术后第0天出院.

主要成果:

一项对2463名患者 (79%的门诊,21%的住院患者) 的综合分析.
门诊PCNL显示总体并发症较少 (RR 0.65) 和更高的成像定义的无结石率 (RR 1.35).
队列之间没有重大并发症,紧急访问或再接收的显著差异;SDD亚组分析没有产生显著差异. 每个案例的成本节省从932美元到5327美元不等.

结论:

门诊PCNL对于精心挑选的患者来说是一种安全有效的方法.
潜在的选择偏差可能会影响结果,但目前的纳入标准似乎是安全的.
这些发现支持在适当的患者群体中更广泛地采用门诊PCNL.

关键词:

这是一个循环的门诊机构.在住院患者的治疗中.这是一个元分析.最少侵入性的外科手术程序.通过皮肤进行nephrolithotomy.系统性审查系统性审查尿病是一种尿病.泌尿病学泌尿病学泌尿病学

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