PDF(Pubmed)
Abstract：
UNASSIGNED: The debate regarding the optimal drainage method for acute obstructive upper urinary tract infection persists, focusing on the choice between percutaneous nephrostomy (PCN) and retrograde ureteral stenting (RUS).
UNASSIGNED: This study aims to systematically examine the perioperative outcomes and safety associated with PCN and RUS in treating acute obstructive upper urinary tract infections.
UNASSIGNED: A comprehensive investigation was conducted using the Medline, Embase, Web of Science, and Cochrane databases up to December 2022, following the guidelines of the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. The utilized keywords included \'PCN\', \'RUS\', \'acute upper obstructive uropathy\', and \'RCT\'. Inclusion criteria encompassed studies providing accurate and analyzable data, which incorporated the total subject count, perioperative outcomes, and complication rates. The assessed perioperative outcomes included fluoroscopy time, normalization of temperature, normalization of serum creatinine, normalization of white blood cell (WBC) count, and operative time. Safety outcomes encompassed failure rate, intraoperative and postoperative hematuria, postoperative fever, postoperative pain, and postoperative nephrostomy tube or stent slippage rate. The study protocol was prospectively registered at PROSPERO (CRD42022352474).
UNASSIGNED: The meta-analysis encompassed 7 trials involving 727 patients, with 412 assigned to the PCN group and 315 to the RUS group. The outcome of the meta-analysis unveiled a reduced occurrence of postoperative hematuria in the PCN group [odds ratio (OR) = 0.54, 95% confidence interval (CI) 0.30-0.99, p = 0.04], along with a decreased frequency of insertion failure (OR = 0.42, 95% CI 0.21-0.81, p = 0.01). In addition, the RUS group exhibited a shorter fluoroscopy time than the PCN group (mean difference = 0.31, 95% CI 0.14-0.48, p = 0.0004).
UNASSIGNED: Given the significant impact of hematuria and catheterization failure on postoperative quality of life, the preference for PCN appears more advantageous than RUS.
Meta-analysis of perioperative outcomes and safety of percutaneous nephrostomy vs retrograde ureteral stenting in the treatment of acute obstructive upper urinary tract infection The optimal drainage method for acute obstructive upper urinary tract infection between PCN and RUS is currently debatable. Our meta-analysis found PCN performed better than RUS in hematuria and catheterization failure rate, although PCN was associated with longer exposure time.
UNASSIGNED: This study aims to systematically examine the perioperative outcomes and safety associated with PCN and RUS in treating acute obstructive upper urinary tract infections.
UNASSIGNED: A comprehensive investigation was conducted using the Medline, Embase, Web of Science, and Cochrane databases up to December 2022, following the guidelines of the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. The utilized keywords included \'PCN\', \'RUS\', \'acute upper obstructive uropathy\', and \'RCT\'. Inclusion criteria encompassed studies providing accurate and analyzable data, which incorporated the total subject count, perioperative outcomes, and complication rates. The assessed perioperative outcomes included fluoroscopy time, normalization of temperature, normalization of serum creatinine, normalization of white blood cell (WBC) count, and operative time. Safety outcomes encompassed failure rate, intraoperative and postoperative hematuria, postoperative fever, postoperative pain, and postoperative nephrostomy tube or stent slippage rate. The study protocol was prospectively registered at PROSPERO (CRD42022352474).
UNASSIGNED: The meta-analysis encompassed 7 trials involving 727 patients, with 412 assigned to the PCN group and 315 to the RUS group. The outcome of the meta-analysis unveiled a reduced occurrence of postoperative hematuria in the PCN group [odds ratio (OR) = 0.54, 95% confidence interval (CI) 0.30-0.99, p = 0.04], along with a decreased frequency of insertion failure (OR = 0.42, 95% CI 0.21-0.81, p = 0.01). In addition, the RUS group exhibited a shorter fluoroscopy time than the PCN group (mean difference = 0.31, 95% CI 0.14-0.48, p = 0.0004).
UNASSIGNED: Given the significant impact of hematuria and catheterization failure on postoperative quality of life, the preference for PCN appears more advantageous than RUS.
Meta-analysis of perioperative outcomes and safety of percutaneous nephrostomy vs retrograde ureteral stenting in the treatment of acute obstructive upper urinary tract infection The optimal drainage method for acute obstructive upper urinary tract infection between PCN and RUS is currently debatable. Our meta-analysis found PCN performed better than RUS in hematuria and catheterization failure rate, although PCN was associated with longer exposure time.
摘要：
■关于急性阻塞性上尿路感染的最佳引流方法的争论仍然存在，重点是经皮肾造口术（PCN）和逆行输尿管支架置入术（RUS）之间的选择。
■本研究旨在系统地检查PCN和RUS治疗急性梗阻性上尿路感染的围手术期结局和安全性。
■使用Medline进行了全面调查，Embase,WebofScience,和Cochrane数据库截至2022年12月，遵循系统评价和荟萃分析（PRISMA）声明的首选报告项目指南。使用的关键字包括\'PCN\',\'RUS\',急性上段梗阻性尿路病,和\'RCT\'。纳入标准包括提供准确和可分析数据的研究，其中包含了受试者总数，围手术期结局,和并发症发生率。评估的围手术期结果包括透视时间，温度的正常化，血清肌酐正常化，白细胞（WBC）计数的正常化，和手术时间。安全结果包括故障率，术中和术后血尿，术后发热,术后疼痛,及术后肾造瘘管或支架滑脱率。研究方案在PROSPERO（CRD42022352474）进行了前瞻性注册。
■荟萃分析涵盖了7项试验，涉及727名患者，412分配给PCN组，315分配给RUS组。荟萃分析的结果揭示了PCN组术后血尿的发生率降低[比值比（OR）=0.54，95％置信区间（CI）0.30-0.99，p=0.04]，随着插入失败的频率降低(OR=0.42，95%CI0.21-0.81，p=0.01)。此外,RUS组的透视时间短于PCN组(平均差异=0.31,95%CI0.14~0.48,p=0.0004).
■鉴于血尿和导尿失败对术后生活质量的显着影响，对PCN的偏好似乎比RUS更有利。
经皮肾造口术与逆行输尿管支架置入术治疗急性梗阻性上尿路感染的围手术期结局和安全性的Meta分析目前，PCN和RUS之间急性梗阻性上尿路感染的最佳引流方法尚有争议。我们的荟萃分析发现，PCN在血尿和导尿失败率方面优于RUS，尽管PCN与更长的暴露时间有关。
■本研究旨在系统地检查PCN和RUS治疗急性梗阻性上尿路感染的围手术期结局和安全性。
■使用Medline进行了全面调查，Embase,WebofScience,和Cochrane数据库截至2022年12月，遵循系统评价和荟萃分析（PRISMA）声明的首选报告项目指南。使用的关键字包括\'PCN\',\'RUS\',急性上段梗阻性尿路病,和\'RCT\'。纳入标准包括提供准确和可分析数据的研究，其中包含了受试者总数，围手术期结局,和并发症发生率。评估的围手术期结果包括透视时间，温度的正常化，血清肌酐正常化，白细胞（WBC）计数的正常化，和手术时间。安全结果包括故障率，术中和术后血尿，术后发热,术后疼痛,及术后肾造瘘管或支架滑脱率。研究方案在PROSPERO（CRD42022352474）进行了前瞻性注册。
■荟萃分析涵盖了7项试验，涉及727名患者，412分配给PCN组，315分配给RUS组。荟萃分析的结果揭示了PCN组术后血尿的发生率降低[比值比（OR）=0.54，95％置信区间（CI）0.30-0.99，p=0.04]，随着插入失败的频率降低(OR=0.42，95%CI0.21-0.81，p=0.01)。此外,RUS组的透视时间短于PCN组(平均差异=0.31,95%CI0.14~0.48,p=0.0004).
■鉴于血尿和导尿失败对术后生活质量的显着影响，对PCN的偏好似乎比RUS更有利。
经皮肾造口术与逆行输尿管支架置入术治疗急性梗阻性上尿路感染的围手术期结局和安全性的Meta分析目前，PCN和RUS之间急性梗阻性上尿路感染的最佳引流方法尚有争议。我们的荟萃分析发现，PCN在血尿和导尿失败率方面优于RUS，尽管PCN与更长的暴露时间有关。
