scholarly journals Comparison Between Single-Use Flexible Ureteroscope and Reusable Flexible Ureteroscope for Upper Urinary Calculi: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Chunyang Meng ◽  
Lei Peng ◽  
Jinze Li ◽  
Yunxiang Li ◽  
Jinming Li ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Urinary Calculi ◽  
Length Of Hospital Stay ◽  
Cochrane Library ◽  
Flexible Ureteroscope ◽  
Estimated Blood Loss ◽  
Stone Free Rate ◽  
Grade Ii ◽  
Single Use ◽  
Free Rate

Objective: This article explores the differences in the effectiveness and safety of the treatment of the upper urinary calculi between single-use flexible ureteroscope (su-fURS) and reusable flexible ureteroscope (ru-fURS).Methods: We systematically searched PubMed, Embase, Cochrane Library, Scopus database, and CNKI databases within a period from the date of database establishment to November 2020. Stata 16 was used for calculation and statistical analyses.Results: A total of 1,020 patients were included in the seven studies. The statistical differences were only found in the Clavien–Dindo grade II postoperative complication [odds ratio (OR) 0.47; 95% CI 0.23–0.98; p = 0.04]. No significant statistical differences were observed in operative time (OT), estimated blood loss (EBL), length of hospital stay (LOS), and stone-free rate (SFR).Conclusion: Our meta-analysis results demonstrate that su-fURS, compared with ru-fURS, has similar effectiveness and better security for treating upper urinary calculi.

scholarly journals Evaluation of three stone-scoring systems for predicting SFR and complications after percutaneous nephrolithotomy: a systematic review and meta-analysis

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kehua Jiang ◽  
Fa Sun ◽  
Jianguo Zhu ◽  
Guangheng Luo ◽  
Peng Zhang ◽  
...  
Keyword(s):  
Scoring System ◽  
Meta Analysis ◽  
Scoring Systems ◽  
Lower Proportion ◽  
Systematic Evaluation ◽  
Cochrane Library ◽  
Stone Free Rate ◽  
The Cochrane Library ◽  
Staghorn Stone ◽  
Free Rate

Abstract Background Clinical studies assessing the feasibility and accuracy of three stone scoring systems’s (SSSs: Guy’s stone score, CROES nomogram and S.T.O.N.E nephrolithometry scoring system) have reported contradictory outcomes. This systematic evaluation was performed to obtain comprehensive evidence with regard to the feasibility and accuracy of three SSSs. Methods A systematic search of Embase, Pubmed, Medline, and the Cochrane Library was conducted to identify studies that compared three SSSs up to Mar 2018. Patients were categorized according to stone free (SF) and no-stone free (NSF), Outcomes of interest included perioperative variables, stone-free rate (SFR), and complications. Results Ten studies estimating three SSSs were included for meta-analysis. The results showed that SF patients had a significantly lower proportion of male (OR = 1.48, P = 0.0007), lower stone burden (WMD = -504.28, P < 0.0001), fewer No of involved calyces (OR = -1.23, P = 0.0007) and lower proportion of staghorn stone (OR = 0.33, P < 0.0001). Moreover, SF patients had significantly lower score of Guy score (WMD = -0.64, P < 0.0001), but, S.T.O.N.E. score (WMD = -1.23, P < 0.0001) and a higher score of CROES nomogram (WMD = 29.48, P = 0.003). However, the comparison of area under curves (AUC) of predicting SFR indicated that there was no remarkable difference between three SSSs. Nonetheless, Guy score was the only stone scoring system that predicted complications after PCNL (WMD = -0.29, 95% CI: − 0.57 to − 0.02, P = 0.03). Conclusions Our meta-analysis indicated that the three SSSs were equally, feasible and accurate for predicting SFR after PCNL. However, Guy score was the only stone scoring system that predicted complications after PCNL.

scholarly journals Did we take physical therapy serious after ESWL and retrograde intrarenal surgery

2020 ◽  
Author(s):  
Linjie Peng ◽  
Junjun Wen ◽  
Guohua Zeng ◽  
Wen Zhong
Keyword(s):  
Physical Therapy ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Review Of Literature ◽  
Retrograde Intrarenal Surgery ◽  
Stone Free Rate ◽  
Randomized Control ◽  
And Inversion ◽  
Free Rate

Abstract Background: Physical therapy, including percussion, inversion, vibration and combinations, was clinically administrated to improve the stone-free rate (SFR). The present study aimed to investigate the role of physical after ESWL and retrograde intrarenal surgery (RIRS).Methods: Systematic review of literature from PubMed, Scopus, Cochrane library and Embase which focused on physical therapy after ESWL and RIRS was administrated, meta-analysis was performed, SFR and complications was investigated.Results: A total of 8 prospective studies with 1065 patients were enrolled, including 7 randomized control trials and 1 prospective study. 1 study was designed on RIRS and the rest 7 studies were on ESWL. Compared to observation group, physical therapy provided a higher SFR (OR= 3.38, 95% CI: 2.45-4.66, p< 0.0001) at any time point (week1, week2 and month1), especially the SFR in lower calyceal stone (OR: 3.51; 95%CI: 2.21-5.55; p<0.0001) and upper ureteral stone (OR:2.79; 95%CI:1.62-4.81; p=0.0002). In subgroup analysis, EPVL (external physical vibration lithecbole, OR:3.47; 95%CI:2.24-5.37; p<0.0001) and PDI (percussion, diuresis and inversion, OR:3.24; 95%CI:2.01-5.21; p<0.0001) were both effective. Complications such as hematuria, lumbago, dizziness and urinary tract infection were all comparable (OR: 0.84; 95% CI: 0.62-1.13; p = 0.237). Conclusions: Physical therapy was effective and safe in increasing the SFR after ESWL and RIRS without significant side effects, especially for lower calyceal stone and upper ureteral or renal pelvic stone. A consistent protocol for physical therapy after lithotripsy was needed to be built, which would promote a better final stone-free. And the role of drinking enough water, furosemide and tamsulosin in physical therapy required further test. Review Registration: PROSPERO 2019 CRD42019130228.

scholarly journals The impact of mini-invasive right hepatectomy in the setting of living donation: a meta-analysis

2021 ◽  
Author(s):  
Quirino Lai ◽  
Francesco Giovanardi ◽  
Gianluca Mennini ◽  
Giammauro Berardi ◽  
Massimo Rossi
Keyword(s):  
Liver Resection ◽  
Blood Loss ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Medical Community ◽  
Cochrane Library ◽  
Right Hepatectomy ◽  
Donor Liver Transplantation ◽  
Estimated Blood Loss ◽  
The Impact

AbstractAdult-to-adult living-donor liver transplantation (A2ALDLT) represents a challenging procedure, mainly when the right hepatic lobe is donated. Therefore, especially in Western countries, the medical community still considers it a “risky procedure”. The present meta-analysis investigated the postoperative results reported in donors undergoing right hepatectomy for A2ALDLT through a minimally invasive liver resection (MILR) vs. open liver resection (OLR) approach, with the intent to clarify the hypothesis that the MILR approach should minimize the risks for the donor. A systematic literature search was performed using MEDLINE-PubMed, Cochrane Library, and EMBASE electronic databases. The primary outcome investigated was the complication rate after transplant. Fifteen studies were included (n = 2094; MILR = 553 vs. OLR = 1541). The MILR group only merged the statistical relevance in terms of advantage in terms of a lower number of complications (OR = 0.771, 95% CI 0.578–1.028; P value = 0.077). Investigating the complications ≥ IIIa according to the Dindo-Clavien classification, the estimated blood loss, and the length of hospital stay, no statistical difference was reported between the two groups. MILR represents a novel and promising approach for improving the results in A2ALDLT. However, no benefits have been reported regarding blood loss, length of stay, and postoperative complications. More extensive experiences are needed to re-evaluate the impact of MILR in right lobe live donation.

scholarly journals Efficacy and safety of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for treatment of large renal stones: a meta-analysis

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098313
Author(s):  
Tie Mao ◽  
Na Wei ◽  
Jing Yu ◽  
Yinghui Lu
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Percutaneous Nephrolithotomy ◽  
Meta Analysis ◽  
Renal Stones ◽  
Efficacy And Safety ◽  
Complementary Treatment ◽  
Laparoscopic Pyelolithotomy ◽  
Stone Free Rate ◽  
Free Rate

Background We aimed to compare the efficacy and safety of laparoscopic pyelolithotomy (LPL) versus percutaneous nephrolithotomy (PCNL) for treating renal stones larger than 2 cm. Methods We searched the PubMed, Embase, Web of Science, SinoMed, and Chinese National Knowledge Infrastructure databases for studies that compared the surgical outcomes of LPL and PCNL. We conducted a meta-analysis of the retrieved studies, expressed as weighted mean difference or risk ratios with 95% confidence intervals. Results We included 25 studies (1831 patients). LPL was associated with a significantly higher stone-free rate, lower rates of blood loss, complementary treatment, blood transfusion, and complications, and less reduction in hemoglobin level compared with PCNL. LPL and PCNL were similar in terms of duration of hospital stay, conversion rate, changes in glomerular filtration rate and creatinine level, and mean time of postoperative analgesia. However, LPL was associated with a longer operation time than PCNL. Conclusion LPL appears to be more effective and safer than PCNL in patients with large renal stones, by increasing the stone-free rate and reducing blood loss, complementary treatment, blood transfusion, and complications compared with PCNL. LPL may thus be a useful modality for treating patients with large renal stones.

Effect of Oral Motor Intervention on Oral Feeding in Preterm Infants: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-11
Author(s):  
Danna Chen ◽  
Zhen Yang ◽  
Chujie Chen ◽  
Pu Wang
Keyword(s):  
Weight Gain ◽  
Hospital Stay ◽  
Preterm Infants ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Oral Feeding ◽  
Transition Time ◽  
Cochrane Library ◽  
Oral Motor ◽  
Feeding Efficiency

Objective This review article aimed to explore the effect of oral motor intervention on oral feeding in preterm infants through a meta-analysis. Method Eligible studies were retrieved from four databases (PubMed, Embase, Cochrane Library, and Web of Science) up to July 2020 and screened based on established selection criteria. Thereafter, relevant data were extracted and heterogeneity tests were conducted to select appropriate effect models according to the chi-square test and I 2 statistics. Assessment of risk of bias was performed among the included studies. Finally, a meta-analysis was carried out to evaluate the effect of oral motor intervention in preterm infants according to four clinical indicators: transition time for oral feeding, length of hospital stay, feeding efficiency, and weight gain. Results Eighteen randomized controlled trials with 848 participants were selected to evaluate the effect of oral motor intervention on preterm infants. The meta-analysis results revealed that oral motor intervention could effectively reduce the transition time to full oral feeds and the length of hospital stay as well as increase feeding efficiency and weight gain. Conclusions Oral motor intervention was an effective way to improve oral feeding in preterm infants. It is worthy to be used widely in hospitals to improve the clinical outcomes of preterm infants and reduce the economic burdens of families and society. Future studies should seek to identify detailed intervention processes and intervention durations for clinical application.

scholarly journals Comparison of Retzius-Sparing Robot-Assisted Radical Prostatectomy vs. Conventional Robot-Assisted Radical Prostatectomy: An Up-to-Date Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiang-Nan Xu ◽  
Zhen-Yu Xu ◽  
Hu-Ming Yin
Keyword(s):  
Radical Prostatectomy ◽  
Lower Incidence ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Urinary Continence ◽  
Robot Assisted ◽  
Postoperative Continence ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Anterior Prostate

Background: The Retzius space-sparing robot-assisted radical prostatectomy (RS-RARP) has shown better results in urinary continence, but its efficacy and safety compared to conventional robot-assisted radical prostatectomy (c-RARP) remain controversial.Material and Methods: A research was conducted in Medline via PubMed, Cochrane Library, EMBASE, and Web of Science up to January 4, 2021, to identify studies comparing RS-RARP to c-RARP. We used RevMan 5.3 and STATA 14.0 for meta-analysis.Results: A total of 14 studies involving 3,129 participants were included. Meta-analysis showed no significant difference in positive surgical margins (PSMs), but the RS-RARP group had significantly higher PSM rates in the anterior site [odds ratio (OR) = 2.25, 95% CI: 1.22–4.16, P = 0.01]. Postoperative continence in RS-RARP group at 1 month (OR = 5.72, 95% CI: 3.56–9.19, P &lt; 0.01), 3 months (OR = 6.44, 95% CI: 4.50–9.22, P &lt; 0.01), 6 months (OR = 8.68, 95% CI: 4.01–18.82, P &lt; 0.01), and 12 months (OR = 2.37, 95% CI: 1.20–4.70, P = 0.01) was significantly better than that in the c-RARP group. In addition, the RS-RARP group had a shorter console time (mean difference = −16.28, 95% CI: −27.04 to −5.53, P = 0.003) and a lower incidence of hernia (OR = 0.35, 95% CI: 0.19–0.67, P = 0.001). However, there were no significant differences in estimated blood loss, pelvic lymph node dissection rate, postoperative complications, 1-year-biochemical recurrence rate, and postoperative sexual function.Conclusions: Compared with c-RARP, RS-RARP showed better recovery of continence, shorter console time, and lower incidence of hernia. Although there was no significant difference in overall PSM, we suggest that the surgeon should be more careful if the lesion is in the anterior prostate.

Systematic review and meta-analysis of the influence of prophylactic pyloric balloon dilatation in the prevention of early delayed gastric emptying after oesophagectomy

2021 ◽  
Author(s):  
Mohamed Abdelrahman ◽  
Arun Ariyarathenam ◽  
Richard Berrisford ◽  
Lee Humphreys ◽  
Grant Sanders ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Anastomotic Leak ◽  
Balloon Dilatation ◽  
Delayed Gastric Emptying ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Primary Outcome Measure ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Optimal Approach

SUMMARY Background: Early delayed gastric emptying (DGE) occurs in up to 50% of patients following oesophagectomy, which can contribute to increased anastomotic leak and respiratory infection rates. Although the treatment of DGE in the form of pyloric balloon dilatation (PBD) post-operatively is well established, there is no consensus on the optimal approach in the prevention of DGE. The aim of this review was to determine the efficacy of prophylactic PBD in the prevention of DGE following oesophagectomy. Method: PubMed, MEDLINE and the Cochrane Library (January 1990 to April 2021) were searched for studies reporting the outcomes of prophylactic PBD in patients who underwent oesophagectomy. The primary outcome measure was the rate of DGE. Secondary outcome measures include anastomotic leak rate and length of hospital stay. Results: Three studies with a total of 203 patients [mean age 63 (26–82) years, 162 males (79.8%)] were analyzed. PBD with a 20-mm balloon was performed in 165 patients (46 patients had PBD and botox therapy) compared with 38 patients who had either no intervention or botox alone (14 patients). The pooled rates of early DGE [16.27%, 95% CI (12.29–20.24) vs. 39.02% (38.87–39.17) (P &lt; 0.001)] and anastomotic leak [8.55%, 95% CI (8.51–8.59) vs. 12.23% (12.16–12.31), P &lt; 0.001] were significantly lower in the PBD group. Conclusion: Prophylactic PBD with a 20-mm balloon significantly reduced the rates of early delayed gastric emptying and anastomotic leak following oesophagectomy.

scholarly journals One-shot dilation versus serial dilation technique for access in percutaneous nephrolithotomy: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025871 ◽  
Author(s):  
Pan-xin Peng ◽  
Shi-cong Lai ◽  
Zhen-shan Ding ◽  
Yu-hui He ◽  
Li-hua Zhou ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Postoperative Hospital Stay ◽  
Fluoroscopy Time ◽  
Access Time ◽  
Transfusion Rate ◽  
Stone Free Rate ◽  
Tract Dilation ◽  
Dilation Group ◽  
Dilation Rate ◽  
Free Rate

ObjectiveThe purpose of this study was to systematically review the outcomes of the use of one-shot dilation (OSD) and serial tract dilation for percutaneous nephrolithotomy (PCNL).MethodsA systematic review and meta-analysis was conducted. The randomised controlled trials (RCTs) included in the study were identified from EMBASE, MEDLINE and the Cochrane Central Register of Controlled Trials. The last search was performed on 30 April 2018. Summary effects were calculated as risk ratios (RRs) with 95% CIs or mean differences (MDs) with 95% CIs. The endpoints included access time, fluoroscopy time, successful dilation rate, stone-free rate, postoperative decrease in haemoglobin levels, transfusion rate, complication rate and length of postoperative hospital stay.ResultsA total of seven RCTs were included in the study, with clinical data reported for 697 patients. The overall access time was approximately 110 s shorter in the OSD group than in the serial dilation group (MD, −110.14; 95% CI −161.99 to −58.30; p<0.0001). The fluoroscopy time was shorter with OSD in all RCTs. In addition, the decrease in postoperative haemoglobin levels was approximately 2.3g/L less in patients in the OSD group than in those in the serial dilation group (MD, −0.23; 95% CI−0.39 to −0.07; p=0.004). No relationship was found between the successful dilation rate, stone-free rate, transfusion rate, or complication rate and the method of tract dilation.ConclusionOSD is a safe and efficacious tract dilation technique that can reduce the access time, fluoroscopy time and postoperative decrease in haemoglobin level. No difference was found in the successful dilation rate, stone-free rate, transfusion rate or rate of complications between the OSD and serial dilation groups. The difference in the length of postoperative hospital stay was uncertain. OSD may be a better method of tract creation for PCNL.

scholarly journals Prediction of the stone free rate by using the guy's stone score after percutaneous nephrolithotomy

2019 ◽  
Vol 45 (3) ◽  
pp. 197-200
Author(s):  
Mohammad Shafikul Islam ◽  
Muhammad Hossain ◽  
Md. Saiful Islam ◽  
AKM Khurshidul Alam ◽  
Md. Habibur Rahman Dulal ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Normal Body Mass Index ◽  
Patient Counseling ◽  
Residual Stone ◽  
Female Ratio ◽  
Stone Free Rate ◽  
Grade Ii ◽  
Free Rate ◽  
Grade Iii

Background: Urolithiasis is one of the common diseases of the urinary system, with an incidence of approximately 5-10% among the general population. Among the minimally invasive surgeries, percutaneous nephrolithotomy (PCNL) is the gold standard therapy for large and/or complex renal stones. Objective: The study was carried out to predict the stone-free rate after PCNL by using the Guy's stone score. Methods: This prospective cross-sectional study was conducted in the Department of Urology, Bangabandhu Sheikh Mujib Medical University, (BSMMU), Dhaka from February 2016 to January 2017. The patients with renal stone attending the outpatient department who met the criteria of standard PCNL. Results: Atotal of 52 patients with renal stone were included in this study.  The mean age was to be found 45.3±14.0 with range of 18 to 73 years. Male to female ratio was 3.3:1. Almost three fourth (74.5%) patients had normal body mass index. All patients had normal anatomy. More than half 27 of the (51.9%) patients had found grade I, 10 (19.2%) Grade II, 11(21.2%) Grade III and 4 (7.7%) Grade IV. Nearly two third 34 (65.4%) patients were found total stone cleared and 18(34.6%) had residual stone. Cleared stone was found 23(85.2%) in grade I, 7(70.0%) grade II, 3(27.3%) in grade III and 1(25.0%) in grade IV. Conclusion: Based on the study findings, it may be concluded that higher the GSS less the stone free rate.It will help in better patient counseling preoperatively, and to predict the need for ancillary treatment.

The Self-Retaining Barbed Suture for Parenchymal Repair in Laparoscopic Partial Nephrectomy: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 26 (6) ◽  
pp. 744-752
Author(s):  
Hailun Zhan ◽  
Chunping Huang ◽  
Tengcheng Li ◽  
Fei Yang ◽  
Jiarong Cai ◽  
...  
Keyword(s):  
Renal Function ◽  
Blood Loss ◽  
Hospital Stay ◽  
Partial Nephrectomy ◽  
Operative Time ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
The Self ◽  
Barbed Suture ◽  
Estimated Blood Loss

Objectives. The warm ischemia time (WIT) is key to successful laparoscopic partial nephrectomy (LPN). The aim of this study was to perform a meta-analysis comparing the self-retaining barbed suture (SRBS) with a non-SRBS for parenchymal repair during LPN. Methods. A systematic search of PubMed, Scopus, and the Cochrane Library was performed up to March 2018. Inclusion criteria for this study were randomized controlled trials (RCTs) and observational comparative studies assessing the SRBS and non-SRBS for parenchymal repair during LPN. Outcomes of interest included WIT, complications, overall operative time, estimated blood loss, length of hospital stay, and change of renal function. Results. One RCT and 7 retrospective studies were identified, which included a total of 461 cases. Compared with the non-SRBS, use of the SRBS for parenchymal repair during LPN was associated with shorter WIT ( P < .00001), shorter overall operative time ( P < .00001), lower estimated blood loss ( P = .02), and better renal function preservation ( P = .001). There was no significant difference between the SRBS and non-SRBS with regard to complications ( P = .08) and length of hospital stay ( P = .25). Conclusions. The SRBS for parenchymal repair during LPN can significantly shorten the WIT and overall operative time, decrease blood loss, and preserve renal function.

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