摘要
目的系统性比较腹腔镜切开取石术与输尿管镜碎石术在治疗输尿管上段梗阻性结石方面的临床疗效差异。方法由2名评价员制定相关文献的检索策略及纳入、排除标准。通过在线检索PubMed、荷兰医学文献数据库(EMBASE)、Cochrane临床对照试验数据库、中国知网、万方、维普数据库,并获得有关腹腔镜切开取石术(LU)与输尿管镜碎石术(URSL)在治疗输尿管上段梗阻性结石方面随机对照试验研究(RCT)。检索时间从建库开始至2017年9月。采用RevMan5.3软件对相关文献资料数据进行临床荟萃分析。结果共纳入9篇RCT,相关患者共994例,其中LU组501例,URSL组493例。对9篇RCT研究进行Meta分析后显示:在手术时间(WMD=31.34min,95%CI:16.83~45.85,P<0.01)、住院天数(WMD=1.88d,95%CI:0.93~2.82,P<0.01)方面URSL组要显著优于LU组。但术后患者并发症发生率(OR=0.47%,95%CI:0.32~0.70,P<0.01)、结石清除率(OR=6.63%,95%CI:3.91~11.25,P<0.01)方面LU组要明显优于URSL组。结论虽然URSL在治疗梗阻性上段输尿管结石方面所需要的手术时间及住院天数少于LU,但在术后并发症及结石清除率方面LU效果更好。
Objective To systematically compare the differences of clinical efficacy in the treatment of obstructive upper ureteral stones by laparoscopic lithotomy and transurethral ureteroscope lithotripsy. Methods The search strategy and the inclusion and exclusion criteria were made by two independent reviewers. We searched online PubMed, EMBASE, Cochrane Clinical Controlled Trials Database, China National Knowledge Infrastructure(CNKI), Wang fang and VIP citation database from the inception to September 2017 for randomized controlled trials(RCT)studies, which assessing the efficacy of laparoscopic ureterolithotomy (LU) and transurethral ureteroscope lithotripsy (URSL) for obstructive upper ureteral calculus. RevMan 5.3 software was used to perform a clinical meta-analysis of relevant literature data. Results Nine randomized controlled trials (RCTs) were included, a total of 994 cases of related patients, including LU group of 501 cases, URSL group of 493 cases. The results showed that URSL contained a shorter time of surgery[WMD=31.34 min, 95%CI(16.83, 45.85), P<0.01] and length of hospital stay[WMD=1.88 d, 95%CI(0.93, 2.82), P<0.01] compared with LU group. However, LU group had a lower postoperative complications[OR=0.47%, 95%CI(0.32, 0.70), P<0.01] and higher stone clearance rates[OR=6.63%, 95%CI(3.91, 11.25), P<0.01]than URSL group. Conclusions Although URSL requires less operative time and hospital stay than LU for the treatment of obstructive upper ureteral stones, the postoperative complication and stone clearance rate performance are poor in URSL.
作者
于靳
杜永辉
郑亮
惠鹏宇
胡小剑
倪锋
Yu Jin;Du Yonghui;Zheng Liang;Hui Pengyu;Hu Xiaojian;Ni Feng(Department of Urology, the Second Affiliated Hospital of Xi'an Medical College, Xi'an 710038, China)
出处
《国际泌尿系统杂志》
2019年第3期407-411,共5页
International Journal of Urology and Nephrology
