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Verfasst von:Cracco, Cecilia M. [VerfasserIn]   i
 Knoll, Thomas [VerfasserIn]   i
Titel:Rigid-only versus combined rigid and flexible percutaneous nephrolithotomy
Titelzusatz:a systematic review
Verf.angabe:Cecilia M. Cracco, Thomas Knoll, Evangelos N. Liatsikos, Palle J. Osther, Arthur D. Smith, Roberto M. Scarpa, Cesare M. Scoffone
E-Jahr:2017
Jahr:January 26, 2017
Umfang:12 S.
Fussnoten:Gesehen am 15.11.2018
Titel Quelle:Enthalten in: Minerva urologica e nefrologica
Ort Quelle:Torino : Ed. Minerva Medica, 1998
Jahr Quelle:2017
Band/Heft Quelle:69(2017), 4, Seite 330-341
ISSN Quelle:1827-1758
Abstract:Introduction: Percutaneous nephrolithotomy (PNL) is usually performed worldwide with a rigid-only antegrade approach. Daily practice suggests that adding flexible nephroscopy and/or ureteroscopy to conventional rigid PNL might improve its efficacy and safety, but available evidence is weak. Appraisal of reliable outcomes of such PNL techniques would better guide intraoperative choices and optimize surgical results. Therefore, our objective was to systematically review relevant literature comparing the outcomes of rigid-only PNL and combined flexible PNLs (adding flexible nephroscopy and/or flexible ureteroscopy) for the treatment of large and/or complex upper urinary tract calculi, with regard to efficacy and safety. Evidence acquisition: Ovid MedLine, PubMed, Scopus and Web of Science databases were searched in August 2016 to identify relevant studies. Article selection was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis criteria. Evidence synthesis: Six articles reporting on 666 patients were included: two randomized controlled trials, two retrospective comparative studies and two case series ≥50 patients (one prospective and one retrospective). A narrative synthesis of minor evidences was also prepared. The adjunct of flexible nephroscopy and/or ureteroscopy provided better stone-free rates (range 86.7-96.97%), through a single percutaneous access most of the times and in any position, reducing the need for second-look procedures. Safety of the combined flexible procedures was improved to a variable degree, with a consensual reduction of the mean hospital stay (range 5.1-7 days). Conclusions: The current evidence suggests that patients with large and/or complex urolithiasis might benefit from the adjunct of flexible nephroscopy and/or ureteroscopy to rigid PNL.
DOI:doi:10.23736/S0393-2249.17.02841-7
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: http://dx.doi.org/10.23736/S0393-2249.17.02841-7
 Volltext: https://www.minervamedica.it/en/journals/minerva-urologica-nefrologica/article.php?cod=R19Y2017N04A0330
 DOI: https://doi.org/10.23736/S0393-2249.17.02841-7
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1583739858
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