Complications and outcomes of tubeless versus nephrostomy tube in percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized clinical trials

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dc.authorid0000-0002-6308-1763
dc.contributor.authorGauhar, Vineet
dc.contributor.authorTraxer, Olivier
dc.contributor.authorRojo, Esther Garcia
dc.contributor.authorScarcella, Simone
dc.contributor.authorPavia, Maria Pia
dc.contributor.authorChan, Vinson Wai-Shun
dc.contributor.authorPretore, Eugenio
dc.contributor.authorWroclawski, Marcelo Langer
dc.contributor.authorCorrales, Mariela
dc.contributor.authorTiong, Ho Yee
dc.contributor.authorLim, Ee Jean
dc.contributor.authorTeoh, Jeremy Yuen-Chun
dc.contributor.authorHeng, Chin-Tiong
dc.contributor.authorde la Rosette, Jean J. M. C. H.
dc.contributor.authorSomani, Bhaskar Kuman
dc.contributor.authorCastellani, Daniele
dc.date.accessioned2022-11-16T10:30:46Z
dc.date.available2022-11-16T10:30:46Z
dc.date.issued2022
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractWe aimed to perform a systematic review of randomized trials to summarize the evidence on the safety and stone-free rate after Tubeless percutaneous nephrolithotomy (PCNL) (ureteral stent/catheter, no nephrostomy) compared to Standard PCNL (nephrostomy, with/without ureteral stent/catheter) to evaluate if the tubeless approach is better. The inverse variance of the mean difference with a random effect, 95% Confidence Interval (CI), and p values was used for continuous variables. Categorical variables were assessed using Cochran-Mantel-Haenszel method with the random effect model, and reported as Risk Ratio (RR), 95% CI, and p values. Statistical significance was set at p < 0.05 and a 95% CI. 26 studies were included. Mean operative time was significantly shorter in the Tubeless group (MD-5.18 min, 95% CI - 6.56, - 3.80, p < 0.00001). Mean postoperative length of stay was also significantly shorter in the Tubeless group (MD-1.10 day, 95% CI - 1.48, - 0.71, p < 0.00001). Incidence of blood transfusion, angioembolization for bleeding control, pain score at the first postoperative day, the number of patients requiring postoperative pain medication, fever, urinary infections, sepsis, perirenal fluid collection, pleural breach, hospital readmission, and SFR did not differ between the two groups. Incidence of postoperative urinary fistula was significantly lower in the Tubeless group (RR 0.18, 95% CI 0.07, 0.47, p = 0.0005). This systematic review shows that tubeless PCNL can be safely performed and the standout benefits are shorter operative time and hospital stay, and a lower rate of postoperative urinary fistula.
dc.description.sponsorshipUniversita Politecnica delle Marche within the CRUI-CARE Agreementen_US
dc.identifier.citationGauhar, V., Traxer, O., Rojo, E. G., Scarcella, S., Pavia, M. P., Chan, V. W.-S. ... Castellani, D. (2022). Complications and outcomes of tubeless versus nephrostomy tube in percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized clinical trials. Urolithiasis, 50(5), 511-522. https://doi.org/10.1007/s00240-022-01337-y
dc.identifier.doi10.1007/s00240-022-01337-y
dc.identifier.endpage522
dc.identifier.issn2194-7228
dc.identifier.issn2194-7236
dc.identifier.issue5
dc.identifier.pmid35674819
dc.identifier.scopus2-s2.0-85131514813
dc.identifier.scopusqualityQ1
dc.identifier.startpage511
dc.identifier.urihttps://doi.org/10.1007/s00240-022-01337-y
dc.identifier.urihttps://hdl.handle.net/20.500.12511/9974
dc.identifier.volume50
dc.identifier.wos000807920700001en_US
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorde la Rosette, Jean J. M. C. H.
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofUrolithiasisen_US
dc.relation.publicationcategoryDiÄŸer
dc.rightsAttribution 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subjectAmbulatory Surgical Procedures
dc.subjectKidney Stone
dc.subjectPercutaneous Nephrolithotomy
dc.subjectPercutaneous Nephrostomy
dc.titleComplications and outcomes of tubeless versus nephrostomy tube in percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized clinical trials
dc.typeReview Article

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