对双边同期和单边逆行性内手术进行结石的比较元分析
Henrique L Lepine1, Fabio Carvalho Vicentini2,3,4, Alexandre Danilovic5
1University of São Paulo School of Medicine, São Paulo, SP, Brazil.
World journal of urology
|June 26, 2025
概括
双边同期逆行性内手术 (B-RIRS) 提供与单边手术相似的无石头率,但并发症和再治疗率更高,特别是在老年患者中. 仔细选择患者对于B-RIRS的安全至关重要.
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
- 腎石病的治療方法
背景情况:
- 结石对健康造成重大负担,需要有效的治疗策略.
- 逆行性内手术 (RIRS) 是结石去除的一个关键的微创方法.
- 双边同一会期RIRS (B-RIRS) 旨在同时治疗两个脏中的结石,可能减少麻醉暴露.
研究的目的:
- 系统地比较B-RIRS与单边RIRS (U-RIRS) 治疗结石的安全性和疗效.
- 评估无石头率 (SFR),并发症率,再治疗需要,手术时间和住院时间的差异.
主要方法:
- 系统审查和对遵守PRISMA指南的七项比较研究的元分析.
- 主要结局:SFR和并发症 (Clavien-Dindo等级I-V).主要结局:SFR和并发症 (Clavien-Dindo等级I-V).主要结局:SFR和并发症.
- 二次结果:再治疗率,手术时间和住院时间;针对老年人群的小组分析.
主要成果:
- 在B-RIRS和U-RIRS之间的整体SFR没有显著差异 (或0.73).
- B-RIRS与较高的轻微 (OR 2.55) 和重大 (OR 3.16) 并发症相关.
- B-RIRS与增加的再处理率 (OR 2.46) 和更长的操作时间 (MD 24.99 分钟) 相关.
- 老年人群与B-RIRS显示较低的SFR;住院时间类似.
结论:
- B-RIRS提供与U-RIRS相似的SFR,但具有更高的并发症和再治疗风险,特别是在老年或并发症患者中.
- 仔细选择患者可能会减轻增加的风险.
- 需要进一步的随机试验来验证研究结果,并完善B-RIRS的选择标准.
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