Abstract:
Robotic pyelolithotomy continues to gain attention as an alternative to percutaneous nephrolithotomy (PCNL) for managing complex renal stones. We performed a single-arm meta-analysis and systematically searched the English-language literature published in PubMed, Web of Science, Scopus, and Google Scholar databases up to June 2024. The risk of non-randomized bias was assessed using ROBINS-I, and the quality of the literature was assessed using MINORS (Methodological Index for Non-Randomized Studies). Merger parameters were calculated using Stata16/SE under a random-effects model. Five non-comparative single-arm studies were included in the meta-analysis. Results showed that the operative time for robotic pyelolithotomy was 168.10 min (95% CI 133.63, 202.56). The hospital stay was 2.63 days (95% CI 0.96, 4.29), and blood loss was 44.13 ml (95% CI 19.76, 68.51). The stone clearance rate was 87% (95% CI 79-93%). The incidence of minor postoperative complications (Clavien grade I-II) was 23.7% (95% CI 13.4-35.8%), and the incidence of major complications (Clavien grade ≥ III) was 7% (95% CI 0.3-20.7%).The safety and efficacy of robotic pyelolithotomy in treating complex renal stones are acceptable, but future large prospective cohort studies are needed to validate the treatment.
摘要:
机器人肾盂切开取石术作为经皮肾镜取石术(PCNL)治疗复杂肾结石的替代方法继续受到关注。我们进行了单臂荟萃分析,并系统地搜索了发表在PubMed,WebofScience,Scopus,以及截至2024年6月的谷歌学术数据库。使用ROBINS-I评估非随机偏倚的风险,文献质量采用MINORS(非随机研究方法学指数)进行评估.在随机效应模型下使用Stata16/SE计算合并参数。5项非比较性单臂研究纳入荟萃分析。结果显示,机器人肾盂切开取石术的手术时间为168.10min(95%CI133.63,202.56)。住院时间为2.63天(95%CI0.96,4.29),失血量为44.13ml(95%CI19.76,68.51)。结石清除率为87%(95%CI79-93%)。术后轻微并发症(ClavienI-II级)的发生率为23.7%(95%CI13.4-35.8%),主要并发症(Clavien≥III级)的发生率为7%(95%CI0.3-20.7%).机器人肾盂切开取石术治疗复杂肾结石的安全性和有效性是可以接受的,但需要未来的大型前瞻性队列研究来验证该治疗方法.