PDF(Pubmed)
Abstract：
UNASSIGNED: To assess if there is a preferable intervention between retrograde ureteral stent (RUS) and percutaneous nephrostomy (PCN) tube, in cases of upper urinary tract stone obstruction with complications requiring urgent drainage, by evaluating outcomes regarding urinary symptoms, quality of life (QoL), spontaneous stone passage, and length of hospital stays, since there is no literature stating the superiority of one modality over the other.
UNASSIGNED: We searched MEDLINE and other sources for relevant articles in June 2019 without any date restrictions or filters applied. The selection was done first by the title and abstract screening and then by full-text assessment for eligibility. Only randomized controlled trials or cohort studies in patients with hydronephrosis secondary to obstructive urolithiasis that presented comparative data between PCN and RUS placement concerning at least one of the defined outcome measures were included. Lastly, MEDLINE database and PubMed platform were screened again using the same terms, from June 2019 until November 2022.
UNASSIGNED: Of 556 initial articles, seven were included in this review. Most works were considered of moderate-to-high quality. Three studies regarding QoL showed a tendency against stenting, even though only one demonstrated statistically significant negative impact on overall health state. Two works reported significantly more post-intervention urinary symptoms in stenting patients. One article found that PCN is a significant predictor of spontaneous stone passage, when adjusted for stone size and location. Findings on length of hospital stays were not consistent among articles.
UNASSIGNED: PCN appears to be the intervention better tolerated, with less impact on the patient\'s perceived QoL and less post-operative urinary symptoms, in comparison with RUS. Nevertheless, further studies with larger samples and a randomized controlled design are suggested.
UNASSIGNED: We searched MEDLINE and other sources for relevant articles in June 2019 without any date restrictions or filters applied. The selection was done first by the title and abstract screening and then by full-text assessment for eligibility. Only randomized controlled trials or cohort studies in patients with hydronephrosis secondary to obstructive urolithiasis that presented comparative data between PCN and RUS placement concerning at least one of the defined outcome measures were included. Lastly, MEDLINE database and PubMed platform were screened again using the same terms, from June 2019 until November 2022.
UNASSIGNED: Of 556 initial articles, seven were included in this review. Most works were considered of moderate-to-high quality. Three studies regarding QoL showed a tendency against stenting, even though only one demonstrated statistically significant negative impact on overall health state. Two works reported significantly more post-intervention urinary symptoms in stenting patients. One article found that PCN is a significant predictor of spontaneous stone passage, when adjusted for stone size and location. Findings on length of hospital stays were not consistent among articles.
UNASSIGNED: PCN appears to be the intervention better tolerated, with less impact on the patient\'s perceived QoL and less post-operative urinary symptoms, in comparison with RUS. Nevertheless, further studies with larger samples and a randomized controlled design are suggested.
摘要：
■为了评估逆行输尿管支架（RUS）和经皮肾造口术（PCN）之间是否有更好的干预措施，在上尿路结石梗阻并需要紧急引流的情况下，通过评估关于泌尿症状的结果，生活质量（QoL），自发的结石通道，以及住院时间,因为没有文献说明一种模式优于另一种模式。
■我们在2019年6月搜索了MEDLINE和其他来源的相关文章，没有应用任何日期限制或过滤器。首先通过标题和摘要筛选进行选择，然后通过全文评估资格。仅纳入阻塞性尿路结石继发肾积水患者的随机对照试验或队列研究，这些研究提供了PCN和RUS放置之间的比较数据，涉及至少一种定义的结局指标。最后,再次使用相同的术语筛选MEDLINE数据库和PubMed平台，从2019年6月到2022年11月。
■在556篇初始文章中，这次审查包括了七项。大多数作品被认为是中等到高质量的。关于QoL的三项研究显示了反对支架植入的趋势，即使只有一个人对整体健康状况有统计学意义的负面影响。两项工作报告了支架置入患者的干预后泌尿系统症状明显更多。一篇文章发现PCN是自发结石通过的重要预测因子，当调整石头的大小和位置。关于住院时间长短的研究结果在文章中并不一致。
■PCN似乎是耐受性更好的干预措施，对患者的感知QoL影响较小，术后泌尿症状较少，与RUS相比。然而，建议采用更大样本和随机对照设计进行进一步研究。
■我们在2019年6月搜索了MEDLINE和其他来源的相关文章，没有应用任何日期限制或过滤器。首先通过标题和摘要筛选进行选择，然后通过全文评估资格。仅纳入阻塞性尿路结石继发肾积水患者的随机对照试验或队列研究，这些研究提供了PCN和RUS放置之间的比较数据，涉及至少一种定义的结局指标。最后,再次使用相同的术语筛选MEDLINE数据库和PubMed平台，从2019年6月到2022年11月。
■在556篇初始文章中，这次审查包括了七项。大多数作品被认为是中等到高质量的。关于QoL的三项研究显示了反对支架植入的趋势，即使只有一个人对整体健康状况有统计学意义的负面影响。两项工作报告了支架置入患者的干预后泌尿系统症状明显更多。一篇文章发现PCN是自发结石通过的重要预测因子，当调整石头的大小和位置。关于住院时间长短的研究结果在文章中并不一致。
■PCN似乎是耐受性更好的干预措施，对患者的感知QoL影响较小，术后泌尿症状较少，与RUS相比。然而，建议采用更大样本和随机对照设计进行进一步研究。
