Navigation auf zora.uzh.ch

Search ZORA

ZORA (Zurich Open Repository and Archive)

The fight between PCNL, laparoscopic and robotic pyelolithotomy: do we have a winner? A systematic review and meta-analysis

Mantica, Guglielmo; Balzarini, Federica; Chierigo, Francesco; Keller, Etienne X; Talso, Michele; Emiliani, Esteban; Pietropaolo, Amelia; Papalia, Rocco; Scarpa, Roberto M; Terrone, Carlo; Esperto, Francesco (2022). The fight between PCNL, laparoscopic and robotic pyelolithotomy: do we have a winner? A systematic review and meta-analysis. Minerva urology and nephrology, 74(2):169-177.

Abstract

INTRODUCTION

The aim of this systematic review and meta-analysis was to provide an updated comparison between the currently available minimally invasive approaches (PCNL, laparoscopic [LP] and robotic pyelolithotomy [RP]) for the management of large renal stones.

EVIDENCE ACQUISITION

An electronic search of the current literature was conducted through the Medline and NCBI PubMed, Embase, Scopus and Cochrane Collaboration Central Register of Controlled Clinical Trials databases in March 2021. Studies about minimally-invasive treatment for kidney stones were considered. Inclusion criteria were: studies evaluating patients with large renal calculi (≥2 cm); the comparison of at least two of the three approaches (PCNL, LP, RP), and reporting data suitable for meta-analysis evaluation. Patients with concomitant management for ureteropelvic junction obstruction (UPJ-O) were excluded.

EVIDENCE SYNTHESIS

Overall, 17 reports were considered for qualitative and quantitative synthesis, for a total cohort of 1079 patients, of which 534 with PCNL, 525 treated with LP, and 20 with RP. Of those, 16 compared PCNL with LP, while only 1 study compared LP with RP. PCNL mean operative time was statistically significantly shorter than LP and RP while mean estimated blood loss was statistically significantly higher for PNCL. No statistically significant differences were recorded among the three surgical approaches. Finally, PCNL demonstrated slightly, albeit statistically significant lower stone free rate when compared with LP.

CONCLUSIONS

PCNL, LP and RP may be safely and efficiently used to manage large renal stones. All three procedures showed reasonably low rate of complications with a satisfactory stone clearance rate.

Additional indexing

Contributors:European Society of Residents in Urology (ESRU) and Young Academic Urologists (YAU)
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Urological Clinic
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Nephrology
Health Sciences > Urology
Health Sciences > General Medicine
Language:English
Date:April 2022
Deposited On:09 Feb 2023 16:02
Last Modified:29 Oct 2024 02:37
Publisher:Edizioni Minerva Medica
ISSN:2724-6051
OA Status:Closed
Publisher DOI:https://doi.org/10.23736/S2724-6051.21.04587-0
PubMed ID:35147384
Full text not available from this repository.

Metadata Export

Statistics

Citations

Dimensions.ai Metrics
15 citations in Web of Science®
15 citations in Scopus®
Google Scholar™

Altmetrics

Authors, Affiliations, Collaborations

Similar Publications