Upper pole access is safe and effective for pediatric percutaneous nephrolithotomy

Öner, Sedat; Akgül, Ahsen Karagözlü; Demirbaş, Murat; Önen, Efe; Aydos, Murat; Erdoğan, Abdullah

doi:10.1016/j.jpurol.2017.12.013

Cited by 9 publications

(9 citation statements)

References 30 publications

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“…The funnel plot was asymmetric, but Egger’s test detected no publication bias ( P = 0.074) ( Figure 3C ). Hospital stay comparison was conducted among eight studies (672 superior calyceal access, 3,839 other calyceal access) ( 3 – 7 , 12 , 13 , 17 ), and we found that there was no significant difference (IVM, SMD: 0.07, 95% CI, −0.09, 0.22, P = 0.38, Figure 5B ) without significant heterogeneity ( I 2 = 42%, P = 0.10). No publication bias was detected by funnel plot ( Figure 3D ) and Egger’s test ( P = 0.408).…”

Section: Resultsmentioning

confidence: 84%

“…After database search, 778 studies were identified. Original data from 16 research studies were extracted, and after applying screening techniques and quality assessments, they were included in the quantitative analysis (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). The flowchart for screening is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…There were 16 studies (comprising 8,451 participants, 2,288 superior calyceal access and 6,163 other calyceal access) included in the comparison of failed stone clearance (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). In the overall synthesis, superior calyceal access could offer less failed stone clearance (higher stone-free rate) than other calyceal access [Mantel-Haenszel statistic (M-H) random model, OR: 0.64, 95% CI, 0.47-0.88, P = 0.006, Figure 2A].…”

Section: Resultsmentioning

confidence: 99%

“…There were also 16 studies (comprising 8,451 participants, 2,288 superior calyceal access and 6,163 other calyceal access) included in the complication comparison meta-analysis (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). In the overall synthesis, no significant complication difference was detected between superior calyceal access and other calyceal access (M-H random model, OR: 1.10, 95% CI, 0.78-1.56, P = 0.57, Figure 2C).…”

Section: Resultsmentioning

confidence: 99%

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Superior calyceal access vs. other calyceal access in percutaneous nephrolithotomy: A systematic review and meta-analysis

Lin

Luo

et al. 2022

Front. Surg.

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PurposeTo evaluate the superior calyceal access’s performance and safety in relation to other calyceal access during percutaneous nephrolithotomy (PCNL).MethodsThe suggested reporting items for systematic reviews and meta-analysis were used to conduct this meta-analysis (PRISMA). To find pertinent studies for this meta-analysis, we searched PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI). Operation time and hospital stay are two secondary outcomes, whereas failed stone clearance and complication events are the two major outcomes. Utilizing Stata 15.0, RevMan 5.3, and R 4.0.2, relative data were extracted and evaluated.ResultsThis meta-analysis was based on 16 studies with 8,541 individuals. Pooled results suggested that superior calyceal access could offer fewer failed stone clearance [odds ratio (OR): 0.64, 95% confidence interval (CI), 0.47–0.88, P = 0.006] and lower additional puncture rate (OR: 0.35, 95% CI, 0.24–0.51, P < 0.001) than other calyceal access. No complication difference was found (OR: 1.10, 95% CI, 0.78–1.56, P = 0.57). Superior calyceal access could offer shorter operation time [standard mean difference (SMD): −0.57, 95% CI, −0.98 to −0.15, P = 0.007]. No hospital stay difference was found (SMD: 0.07, 95% CI, −0.09 to 0.22, P = 0.38). Large heterogeneity was detected in stone clearance comparison (I2 = 71%, P < 0.001) and operation time (I2 = 97%, P < 0.001). The stone clearance comparison also identified significant publication bias (P = 0.026). These defects weaken the credibility of the results.ConclusionSuperior calyceal access in PCNL may result in a higher stone clearance rate, a lower rate of subsequent punctures, and a faster operation duration with no increase in postoperative complications or hospital stay for kidney stone patients, despite the significant heterogeneity and publication bias. By conducting bigger randomized controlled studies, this discovery still has to be confirmed.

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Section: Resultsmentioning

confidence: 84%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Superior calyceal access vs. other calyceal access in percutaneous nephrolithotomy: A systematic review and meta-analysis

Lin

Luo

et al. 2022

Front. Surg.

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“…By taking the location of the stone and stone burden into consideration, access to renal collecting system is obtained from different calyceal accesses. A proper access is required to provide complete removal of the stones, to decrease PCNL comorbidity and to prevent complications (4). The upper calyceal access provides excellent access to collect upper pole stones.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Efficacy and Safety of Isolated Single Different Calyx Accesses in Percutaneous Nephrolithotomy

Deger¹,

İzol²,

Ok³

et al. 2019

jus

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What's known on the subject? and What does the study add? We investigated whether there was superiority in different calyceal accesses performed in percutaneous nephrolithotomy operation for renal stone treat. Amaç: Böbrek taşı tedavisinde uygulanan perkütan nefrolitotomi (PNL) operasyonunda izole ve tek giriş olarak yapılan üst, orta ve alt kaliks girişlerinin güvenlik ve etkinliklerini karşılaştırmayı amaçladık. Gereç ve Yöntem: Kliniğimizde Eylül 2007 ve Haziran 2018 tarihleri arasında böbrek taşı nedeniyle izole tek giriş ile PNL yapılan hastalar retrospektif olarak incelendi. Hastalar izole tek üst kaliks girişi (grup 1), izole tek orta kaliks girişi (grup 2) ve izole tek alt kaliks girişi (grup 3) olmak üzere üç gruba ayrıldı. Hastaların demografik özelikleri, taş boyutu ve lokalizasyonu, operasyona ait veriler, postoperatif sonuçlar ve komplikasyonlar açısından karşılaştırıldı. Öz Objective: We aimed to compare the safety and efficacy of upper, middle and lower calyx accesses obtained as isolated and single access in percutaneous nephrolithotomy (PCNL) operation which is performed for treating renal stones. Materials and Methods: The records of patients who had undergone PCNL via isolated single pole access due to renal stone between September 2007 and June 2018 were retrospectively evaluated. The patients were divided into three groups as isolated single upper calyceal access patients (group 1), isolated single middle calyceal access patients (group 2) and isolated single lower calyceal access patients (group 3). The patient groups were compared in terms of patient characteristics, stone size and location, operative data, postoperative outcomes and complications. Results: Fifty-seven (2.8%) patients who underwent isolated single calyceal access PCNL were included in group 1 (upper calyx), 542 (26.9%) in group 2 (middle calyx) and 1427 (70.4%) were included in group 3 (lower calyx). The mean age of the patients in groups 1, 2 and 3 was 43.09±15.00, 38.23±22.47 and 39.40±19.93, respectively. A thousand hundred and seventy-six (58%) patients were male and 850 (42%) were female. The mean stone burden was 367.19±266.48, 335.7±301.85 and 353.73±346.47 mm2 in groups 1, 2 and 3, respectively and there was no statistically significant difference between the groups (p=0.45, p=0.77, p=0.29, respectively). The mean operative time, mean fluoroscopy time, and mean nephrostomy time, and the mean length of hospitalization were statistically significantly longer in group 2 than in group 3. Stone-free rates in patients with clinically insignificant stones (SF + CIRF) were 89.5%, 89.6% and 91.6% in group 1, 2 and 3, respectively and there was no statistically significant difference between the groups (p=0.25, p=0.43 and p=0.6 respectively). There was no significant difference between the three groups in terms of postoperative fever, blood transfusion and overall complications. Conclusion: As a result, different isolated single calyceal accesses do not have superiority over each other in terms of stone-free rate and complica...

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Retrorenal colon in pediatric patients with urolithiasis: Is the supine position for PCNL advantageous?

Emiliani

Madarriaga

Llorens

et al. 2022

Journal of Pediatric Urology

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Upper pole access is safe and effective for pediatric percutaneous nephrolithotomy

Cited by 9 publications

References 30 publications

Superior calyceal access vs. other calyceal access in percutaneous nephrolithotomy: A systematic review and meta-analysis

Superior calyceal access vs. other calyceal access in percutaneous nephrolithotomy: A systematic review and meta-analysis

Comparison of Efficacy and Safety of Isolated Single Different Calyx Accesses in Percutaneous Nephrolithotomy

Retrorenal colon in pediatric patients with urolithiasis: Is the supine position for PCNL advantageous?

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