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World Journal of Urology
Published in: World Journal of Urology 5/2019

01-05-2019 | Original Article

Ultrasound-guided versus fluoroscopy-guided percutaneous nephrolithotomy: a systematic review and meta-analysis

Authors: Yu-Hsiang Yang, Yu-Ching Wen, Kuan-Chou Chen, Chiehfeng Chen

Published in: World Journal of Urology | Issue 5/2019

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Abstract

Purpose

To evaluate the efficacy and safety of ultrasound-guided (UG) versus fluoroscopy-guided (FG) percutaneous nephrolithotomy (PCNL).

Methods

A systematic search of PubMed (MEDLINE), Embase, and the Cochrane Library was conducted to identify randomized controlled trials that compared UG-PCNL with FG-PCNL, and a meta-analysis of those studies was completed. The primary outcomes assessed were stone-free rate (SFR) and complication rate. Secondary outcomes assessed were the successful access-creation rate, time necessary for entrance into the target calyx, auxiliary procedure rate, transfusion rate, hemoglobin decrease after surgery, surgery duration, and hospital stay.

Results

Eight studies comprising 966 patients were included in the meta-analysis. Compared with FG-PCNL, UG-PCNL had comparable stone-free rates [odds ratio (OR) 0.95; 95% confidence interval (CI) 0.67–1.35; p = 0.79] irrespective of the patient’s position, and a favorable safety profile resulting in a lower complication rate (OR 0.56; 95% CI 0.36–0.86; p = 0.009). No statistical difference was found between UG and FG groups in secondary outcomes.

Conclusions

UG-PCNL is as effective as FG-PCNL and has the advantage of lower complication rates. In addition, UG-PCNL could be performed with patients in the supine position without compromising its efficacy.
Appendix
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Metadata
Title
Ultrasound-guided versus fluoroscopy-guided percutaneous nephrolithotomy: a systematic review and meta-analysis
Authors
Yu-Hsiang Yang
Yu-Ching Wen
Kuan-Chou Chen
Chiehfeng Chen
Publication date
01-05-2019
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 5/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-018-2443-z

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