Safety and Effectiveness of Percutaneous Nephrolithotomy for Patients with Stones in a Solitary Kidney: A Meta-Analysis

Abstract

Percutaneous nephrolithotomy (PCNL) has been widely applied in the treatment of isolated renal stones in recent years. However, its safety and effectiveness for patients with isolated renal stones remains controversial. In this work, “nephrolithiasis”, “stones”, "renal", “nephrolithotomy”, “percutaneous”, “PCNL”, “solitary”, “single”, and “kidney” were taken as key words to search the relevant studies of PCNL in patients with solitary kidney stones in PubMed, Web of Science, and Embase. The type of literature included was case series study, and the search period was from January 1, 1990 to October 31, 2021. Basic data, stone size, stone removal rate (SFR), complications, mean operation time, and mean length of stays were extracted. The quality of the included literature was assessed using the National Institute for Health and Care Excellence (NICE) case series system, data were analysed using metan and metareg commands in Stata14.1, and sensitivity of the included literature was analysed using metaninf. Finally, 14 studies with a total of 1256 patients were included. The mean adjuvant rate of percutaneous nephrolithotomy for solitary kidney stones was 20.3% (95% CI: 11.8%, 28.9%), initial SFR was 71.8% (95% CI: 64.9%, 78.8%), and final SFR was 89.7% (95% CI: 86.0%, 93.4%). The overall complication rate was 25.5% (95% CI: 18.8%, 32.3%), the incidence of major complications was 6.3% (95% CI: 3.8%, 9.3%), the blood transfusion rate was 7.4% (95% CI: 5.3%, 9.9%), and the incidence of fever was 9.1% (95% CI: 5.3%, 13.7%). It is suggested that percutaneous nephrolithotomy has a low complication rate in the treatment of solitary kidney stones.