Urogenit Tract Infect.
2022 Apr;17(1):14-25. 10.14777/uti.2022.17.1.14.
Stone-Free Rates of mPCNL, PCNL, and RIRS: A Systematic Review and Network Meta-Analysis
- Affiliations
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- 1Department of Urology, Inha University College of Medicine, Incheon, Korea
- 2Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
- 3Department of Urology, Suncheon Medical Center, Suncheon, Korea
- 4Department of Urology, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea
- 5Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
- 6Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
- 7Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul, Korea
- KMID: 2529463
- DOI: http://doi.org/10.14777/uti.2022.17.1.14
Abstract
- Purpose
Retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) are performed to treat renal stones, and miniature PCNL (mPCNL) is used as an alternative to conventional PCNL. We conducted a systematic review of published studies regarding RIRS, PCNL, and mPCNL and performed network meta-analysis on successful outcome (stone-free) rates.
Materials and Methods
The PubMed and EMBASE databases were searched up to December 2020. Data extraction formats were used to extract data on successful outcome rates, study designs, numbers of subjects and characteristics, and methods used to treat renal stones (i.e., RIRS, PCNL, or mPCNL).
Results
Data obtained by 25 studies were used to compare the stone-free rates of RIRS, PCNL, and mPCNL; six comparisons of PCNL and mPCNL, seven of mPCNL and RIRS, and 12 of RIRS and PCNL were analyzed. No difference was found between the stone-free rates of PCNL and mPCNL (odds ratio [OR]: 0.96; 95% confidence interval [CI]: 0.51-1.9) by network meta-analysis. However, the stone-free rate of RIRS was lower than that of mPCNL (OR: 0.41; 95% CI: 0.021-0.82) and PCNL (OR: 0.43; 95% CI: 0.22-0.82). Ranking analysis ranked mPCNL as No. 1 and PCNL as No. 2.
Conclusions
PCNL and mPCNL had better stone-free rates than RIRS for the treatment of renal stones, but the treatment outcomes of PCNL and mPCNL were no different.
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