Comparison of flexible ureterorenoscopy and micropercutaneous nephrolithotomy in the treatment for moderately size lower-pole stones

Abstract

We found that microperc was safe and efficacious when used to treat moderate-size LPSs and may be considered as an alternative to F-URS, affording a higher SFR. Our study supports the notion that microperc should play an increasing role in treatment of LPSs.

Micropercutaneous nephrolithotomy versus retrograde intrarenal surgery in the treatment of renal stones: A systematic review and meta-analysis

“…No additional records were identified through the reference lists from included studies. In accordance with our predefined selection criteria, a total of nine eligible studies[ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ] encompassing 381 Microperc cases and 461 RIRS cases were included in our meta-analysis. Characteristics of stone size, stone location, age, gender, BMI(Body Mass Index), time point of assessing outcomes, and modalities of assessing outcomes between Microperc and RIRS were presented in Table 2 .…”

“…As shown in Table 1 , LOE assessments found that two studies met Level 2 criteria and seven studies were Level 3. Following the Newcastle-Ottawa Scale, all included non-RCTs[ 5 , 6 , 7 , 8 , 9 , 11 , 13 ] with scores ≥ 7 were considered to be of high quality. The two RCTs[ 10 , 12 ][ 10 , 12 ][ 10 , 12 ][ 10 , 12 ](Sabnis and Ganesamoni et al, 2013; Kandemir and Guven et al, 2017)(Sabnis and Ganesamoni et al, 2013; Kandemir and Guven et al, 2017)(Kandemiret al 2017,1–6,Sabniset al 2013,355–361)Kandemir et al (2017);Sabnis et al (2013)[ 10 , 12 ][ 10 , 12 ][ 10 , 12 ] assessed by the Cochrane Risk of Bias Tools were scored with five points and three points, respectively.…”

“…Although the heterogeneity was high, all results from subgroup analysis indicated that hemoglobin levels decreased significantly more to Microperc than with RIRS. Armagan, et al[ 5 ] pointed out that some hemorrhage may occur during Microperc because the procedure features puncture.…”

“…Pooled analysis of seven studies revealed no significant difference between Microperc and RIRS in operative time among adult patients. Only 2 studies[ 5 , 6 ] presented the definition of operative time. Operative time was defined as the duration of time from the beginning of renal puncture to the removal of the percutaneous system.…”

“…However, it is unclear whether Microperc is safer than and as effective as RIRS is. Several studies have examined this question[ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ], but the results were inconclusive. The aim of this study was to perform the first meta-analysis of research comparing Microperc with RIRS in the management of kidney stones.…”