■本研究旨在根据体重指数(BMI)评估肥胖和超重个体的经皮肾镜取石术(PCNL)的疗效和安全性。
■我们以电子方式探索了PubMed的数据库,中部,ScienceDirect,Embase,和GoogleScholar数据库,用于调查BMI对PCNL结局的作用的所有类型的比较研究。仅包括将肥胖定义为>30kg/m2的研究。疗效结果是无结石率和手术时间,而安全性结果是并发症和住院时间(LOS)。
■包括101,363名患者的18项研究。我们注意到病态肥胖与正常BMI患者PCNL后的结石发生率没有差异(OR:0.7895%CI,0.57,1.08I2=7%p=0.13),超重与正常(OR:1.0195%CI,0.89,1.15I2=1%p=0.83)和肥胖与正常患者(OR:1.0095%CI,0.87,1.16I2=0%p=0.95)。与正常患者相比,病态肥胖患者(MD:9.3695%CI,2.85,15.88I2=76%p=0.005)和肥胖患者的PCNL手术时间显着增加(MD:2.1595%CI,1.20,3.10I2=0%p<0.00001),但不适用于超重患者。病态肥胖与正常肥胖之间的并发症几率没有差异(OR:1.2695%CI,0.93,1.72I2=0%p=0.13),超重与正常(OR:1.1195%CI,0.96,1.28I2=0%p=0.15),肥胖与正常患者(OR:1.0795%CI,0.91,1.27I2=0%p=0.40)。与正常患者相比,肥胖患者的LOS显着降低(MD:-0.1295%CI,-0.20,-0.04I2=0%p=0.004),但不适用于病态肥胖或超重患者。
■PCNL在病态肥胖中具有相似的疗效和安全性,肥胖,超重患者与正常BMI患者相比,无结石和并发症发生率无差异。证据表明,病态肥胖和肥胖患者的手术时间增加,而后者的LOS可能较短。系统审查注册:https://www。crd.约克。AC.英国/普华永道/,标识符:CRD42022313599。
UNASSIGNED: The current study aimed to assess the efficacy and safety of percutaneous nephrolithotomy (PCNL) in obese and overweight individuals based on body mass index (BMI).
UNASSIGNED: We electronically explored the databases of PubMed, CENTRAL, ScienceDirect, Embase, and Google Scholar databases for all types of comparative studies investigating the role of BMI on PCNL outcomes. Only studies defining obesity as >30 kg/m2 were included. Efficacy outcomes were stone-free rates and operating time while safety outcomes were complications and length of hospital stay (LOS).
UNASSIGNED: Eighteen studies with 101,363 patients were included. We noted no difference in the stone-free rates after PCNL for morbid obese vs normal BMI patients (OR: 0.78 95% CI, 0.57, 1.08 I2 = 7% p = 0.13), overweight vs normal (OR: 1.01 95% CI, 0.89, 1.15 I2 = 1% p = 0.83) and obese vs normal patients (OR: 1.00 95% CI, 0.87, 1.16 I2 = 0% p = 0.95). PCNL operative time was significantly increased in morbid obese (MD: 9.36 95% CI, 2.85, 15.88 I2 = 76% p = 0.005) and obese patients as compared with normal patients (MD: 2.15 95% CI, 1.20, 3.10 I2 = 0% p < 0.00001), but not for overweight patients. There was no difference in the odds of complications between morbid obese vs normal (OR: 1.26 95% CI, 0.93, 1.72 I2 = 0% p = 0.13), overweight vs normal (OR: 1.11 95% CI, 0.96, 1.28 I2 = 0% p = 0.15), and obese vs normal patients (OR: 1.07 95% CI, 0.91, 1.27 I2 = 0% p = 0.40). LOS was significantly reduced in obese patients (MD: -0.12 95% CI, -0.20, -0.04 I2 = 0% p = 0.004) as compared to normal patients, but not for morbid obese or overweight patients.
UNASSIGNED: PCNL has similar efficacy and safety in morbidly obese, obese, and overweight patients as compared to normal BMI patients with no difference in the stone-free and complication rates. Evidence suggests that operating time is increased in morbidly obese and obese patients and the latter may have shorter LOS.Systematic
Review Registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42022313599.