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

PLoS One. 2018 Oct 19;13(10):e0206048. doi: 10.1371/journal.pone.0206048. eCollection 2018.

Abstract

Objective: To compare the efficacy and safety of micropercutaneous nephrolithotomy (Microperc) and retrograde intrarenal surgery (RIRS) in treating renal stones using published literature.

Methods: A systematic literature review was performed on August 21, 2017, using PubMed, Embase, and Cochrane Library databases in accordance with the PRISMA guidelines. Summarized mean differences (MDs) or odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the differences in outcomes between Microperc and RIRS.

Results: A total of nine studies (7 in adult patients and 2 in pediatric patients) containing 842 patients (381 Microperc cases and 461 RIRS cases) with renal stones were included in this analysis. Among the adult patients, Microperc was associated with higher stone-free rate(SFR)(OR: 1.6; 95% CI, 1.03 to 2.48), significantly longer hospital stays (MD: 0.66 day; 95% CI, 0.17 to 1.15), longer fluoroscopy time (MD: 78.12 s; 95% CI, 66.08 to 90.15), and larger decreases in hemoglobin (MD: 0.59 g/dl; 95% CI, 0.16 to 1.02) than was RIRS. No significant differences were observed with respect to operative time, stone-free rate, complication rate or auxiliary procedures.

Conclusions: Our results demonstrated that Microperc might be more effective in adult patients than RIRS will due to its higher SFR. However, longer hospital stays, longer fluoroscopy time and a larger decrease in hemoglobin should be considered cautiously.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Female
  • Hemoglobins / metabolism
  • Humans
  • Infant
  • Kidney / surgery*
  • Kidney Calculi / surgery*
  • Length of Stay
  • Male
  • Middle Aged
  • Nephrostomy, Percutaneous* / adverse effects
  • Operative Time
  • Postoperative Complications / etiology
  • Publication Bias
  • Treatment Outcome
  • Young Adult

Substances

  • Hemoglobins

Grants and funding

This work was financed by grants from the National Natural Science Foundation of China (NO. 81670643), the Collaborative Innovation Project of Guangzhou Education Bureau (NO. 1201620011) the Guangzhou Science Technology and Innovation Commission (No. 201604020001 and No. 201704020193), and the Science and Technology Planning Project of Guangdong Province (No. 2017B030314108).