scholarly journals Single- versus Multiple-Tract Percutaneous Nephrolithotomy in the Surgical Management of Staghorn Stones or Complex Caliceal Calculi: A Systematic Review and Meta-analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Binbin Jiao ◽  
Zhenshan Ding ◽  
Zhenkai Luo ◽  
Shicong Lai ◽  
Xin Xu ◽  
...  

Objective. To assess current evidence on the effectiveness and safety of single- versus multiple-tract percutaneous nephrolithotomy in the surgical management of complex caliceal calculi or staghorn stones through a comprehensive literature review. Methods. A comprehensive literature review of articles investigating the clinical efficacy and safety of single- versus multiple-tract percutaneous nephrolithotomy was performed. Relevant literature was obtained by systematically searching PubMed, EMBASE, and the Cochrane Library through May 2020. We followed the search strategy based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The primary outcomes, including the stone-free rate (SFR), and secondary outcomes (peri- and postoperative complications and operative data) were evaluated using RevMan 5.3 statistical software. Results. Ten studies involving 1844 patients with complex caliceal calculi or staghorn stones met the inclusion criteria. Single-tract percutaneous nephrolithotomy (STPCNL) had noninferior clinical efficacy with respect to the immediate SFR ( odds   ratio   OR = 0.80 , 95% confidence interval (CI) (0.46 to 1.38), p = 0.42 ) and 3-month SFR ( OR = 1.22 , 95% CI (0.38 to 3.92), p = 0.74 ) compared with multiple-tract percutaneous nephrolithotomy (MTPCNL). In addition, pooled analyses showed that STPCNL resulted in significantly lower hemoglobin decreases ( MD = − 0.46 , 95% CI (-0.68 to -0.25), p < 0.0001 ), fewer blood transfusions ( OR = 0.48 , 95% CI (0.34 to 0.67), p < 0.0001 ), and fewer pulmonary complications ( OR = 0.28 , 95% CI (0.09 to 0.83), p = 0.02 ) than MTPCNL. However, the overall evidence was insufficient to suggest a statistically significant difference for other adverse events. Conclusion. This meta-analysis indicated that STPCNL is an effective method for treating complex caliceal calculi or staghorn stones. Compared with MTPCNL, STPCNL not only yields similarly high SFRs but also is associated with many advantages, less blood loss, fewer blood transfusions, and fewer pulmonary complications without an increase in other complications. However, the findings of this study should be further confirmed by well-designed prospective randomized controlled trials (RCTs) with a larger patient series.

2020 ◽  
Vol 12 (20) ◽  
pp. 8390 ◽  
Author(s):  
Linyan Liu ◽  
Zheng Xiang ◽  
Yuyao Liu ◽  
Florian J. Zach ◽  
Nancy McGehee

With the exhibition sector becoming increasingly important for the hospitality and tourism industry, it is critical to understand what drives the success of an exhibition. Through a comprehensive literature review, we first identified two broad categories of factors, namely exhibition attributes and exhibitor perceptions, that influence exhibitor satisfaction and loyalty. Next, a meta-analysis was conducted based on 26 empirical papers studying the Chinese exhibition market to quantitatively evaluate these relationships. The results show that among the exhibition attributes, booth management, service personnel, and exhibition environment are the most important factors affecting exhibitor satisfaction, while exhibition brand is the most important factor affecting loyalty. Among exhibitor perceptions, service quality is more important for satisfaction, while perceived value is more meaningful to loyalty. This study offers insights into strategies for exhibition organizers to cultivate long-term relationships, and to better cope with the challenges of emerging forces such as the Internet.


2019 ◽  
Vol 129 (4) ◽  
pp. 394-400 ◽  
Author(s):  
Narmien Haddad ◽  
Pratima Agarwal ◽  
Jessica R. Levi ◽  
Jeremiah C. Tracy ◽  
Lauren F. Tracy

Objective: To examine the clinical presentation, diagnostic evaluation, and management of Killian–Jamieson diverticula (KJD) through literature review. Methods: A comprehensive literature review was conducted through December 2018 using keywords Killian–Jamieson diverticula/diverticulum. Data extracted included clinical presentation, imaging characteristics, surgical management, and postoperative care. Sources: PubMed and Google Scholar. Results: Sixty-eight cases of KJD in 59 reports (29M:39F; median 58 years old) were identified for review. The most common presentation was dysphagia (n = 39), suspected thyroid nodule (n = 24) and globus (n = 14). The majority of KJD (n = 51) occur on the left, with rare reports of right side (n = 11) and bilateral (n = 5) presentation. Thirty-two cases describe surgical management: 22 utilizing a transcervical approach, with (n = 13) or without (n = 9) cricopharyngeal myotomy; and 10 reported endoscopic surgery. Diverticula managed transcervically averaged 3.8 cm in size in comparison to average 2.8 cm in the endoscopic group. Time to diet initiation after transcervical surgery averaged 4 days versus 2 days after endoscopic surgery. Complications were reported in 2/68 cases; both were diverticula recurrence after endoscopic surgery. Conclusion: Killian–Jamieson diverticula is a rare diagnosis that should be considered in the evaluation of dysphagia, globus, and also suspected thyroid nodule. When patient symptoms warrant intervention, a transcervical approach, with or without cricopharyngeal myotomy, is most commonly utilized. In recent years, an endoscopic approach has been presented as an alternative for smaller diverticula. Further understanding of the optimal treatment and postoperative management for KJD requires larger cohorts. Level of Evidence: 4


2020 ◽  
pp. 1-26
Author(s):  
Chunjiang Yang ◽  
Aobo Chen

BACKGROUND: Despite the obvious importance of emotional labor for employees, organizations, and customers, a lack of coherence and clarity around the construct has impeded its development. OBJECTIVE: Our study aims to provide a comprehensive review of emotional labor spanning about 40 years. METHODS: Our study used a qualitative literature review method along with a theoretically derived path diagram of key emotional labor constructs. We also used meta-analysis to explore the relationship between emotional labor and outcomes in different national contexts. RESULTS: We expect our research to expand the field in five different ways. First, we review contemporary theoretical conceptualizations of emotional labor and its dimensions. Second, we summarize seven existing measures of emotional labor in light of their contents. Third, we map the theoretical and nomological network of emotional labor about its antecedents, outcomes, moderators, mediators. Fourth, we use meta-analysis to explore the relationship between emotional labor and other variables in different contexts. Finally, we conclude by showing a detailed future research agenda to bring the field forward from different perspectives, including theoretical and empirical advancement. CONCLUSIONS: Overall, our review provides a whole picture of where the literature has been and where it should go.


2021 ◽  
Vol 61 (3) ◽  
pp. 673-680
Author(s):  
Tiberiu Augustin Georgescu ◽  
◽  
Antonia-Carmen Lisievici ◽  
Octavian Munteanu ◽  
Florentina Ligia Furtunescu ◽  
...  

2020 ◽  
Vol 4 (11) ◽  
pp. 381-385
Author(s):  
Ramandita Duta Dewangga ◽  
Tarmono Djojodimedjo ◽  
Dyah Erawati

This study purpose to analyze the differences in the effectiveness of PCNL and open surgery in patients with staghorn stones. We searched the literatures from PubMed and ScienceDirect from year 2005 until 2020. The method used in this study was a systematic review with a quantitative statistical approach (meta-analysis) using primary research data. From 4 studies there were 148 cases of PCNL and 98 cases of open surgery. PCNL had lower postoperative stone-free rate than open surgery (OR 0.168). PCNL had a lower final stone-free rate than open surgery (OR 0.603). The number of patients who had complications with PCNL was lower than open surgery (OR 0.451). The number of patients receiving blood transfusions on PCNL was lower than for open surgery (OR 0.494). Patients who received PCNL procedure required a shorter hospital stay than open surgery (MD -3,234). The number of patients who received additional therapy modalities on PCNL was lower than open surgery (OR 1.917). The conclusions obtained in this study indicate that there are differences in the effectiveness of PCNL and open surgery for patients with staghorn stones. Keywords: percutaneous nephrolithotomy; open surgery; staghorn stone


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