单个会话的双边与分阶段的单边结石去除:系统性审查和元分析中的比较结果
Marco Antonio Andrade1,2, Nathan Joseph Silva Godinho3, Lucas Guimarães C R de Amorim3
1School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil. marcojuniorapple@gmail.com.
World journal of urology
|September 29, 2025
概括
与分阶段单边 (SU) 程序相比,单次双边 (SSB) 结石去除提供类似的无结石率和严重并发症率. 然而,SSB涉及更长的操作时间和更多的整体并发症,尽管减少了计划程序.
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.
- 腎石病的管理方法
背景情况:
- 关于双边脏质病的最佳治疗方法存在争议.
- 单次双边 (SSB) 程序旨在减少干预和麻醉暴露.
- 阶段性单边 (SU) 程序是一种替代方案,关于疗效和安全性的讨论正在进行中.
研究的目的:
- 系统地审查和比较SSB与SU对双边脏质病的程序的结果.
- 评估并发症率,无结石率 (SFR),手术时间和需要额外手术的差异.
- 为了确定SSB在管理复杂的石材负担方面是否比SU提供优势.
主要方法:
- 一项系统性审查和元分析,遵循柯克兰和PRISMA指南.
- 包括2002年至2024年间发表的比较SSB和SU方法的研究.
- 数据提取的重点是严重并发症 (Clavien-Dindo等级≥3),整体并发症,SFR,手术时间和计划外干预.
主要成果:
- 分析了13项涉及836,414名患者的研究 (SSB组7,854名患者).
- 在SSB和SU之间,严重并发症率没有显著差异 (RR1.22;P = 0.53).
- 在SSB组中,总体并发症率较高 (RR 1.32;P = 0.007),手术时间较长 (MD 27.93分钟;P = 0.007),以及对非计划干预的需求增加 (RR 1.65;P < 0.00001).
- 在两种方法中都观察到类似的无石头率 (RR 0.89;P = 0.23).
结论:
- SSB 程序提供与 SU 程序相比较的无石头率和严重并发症概况.
- SSB与增加的整体并发症率和更长的手术时间有关.
- 虽然减少了计划程序和麻醉,SSB需要更多的无计划干预,可能会抵消它的好处.
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