Comparison of intrarenal pelvic pressure and postoperative fever between standard- and mini-tract percutaneous nephrolithotomy: a systematic review and meta-analysis of randomized controlled trials

Translational Andrology and Urology
Dechao FengXin Wei

Abstract

High intrarenal pelvic pressure (IPP) induces systemic absorption of irrigation fluid containing bacteria or endotoxins, which is associated with postoperative fever (POF) and even urosepsis. The emphasis of this meta-analysis lies in comparison of IPP and POF between mini-tract percutaneous nephrolithotomy (MPCNL) and standard-tract percutaneous nephrolithotomy (SPCNL). Eligible randomized controlled trials (RCTs) were identified from electronic databases from inception to November 2019. Studies selection, quality assessment, data extraction and analysis were accomplished by two independent reviewers using Cochrane Collaboration's tools. Patients in the MPCNL group experienced higher IPP compared to SPCNL group [mean difference (MD): 8.31, 95% confidence interval (CI): 3.67-12.96, P=0.0005] with highly between-study heterogeneity (P=0.001, I2=85%). Notably, the IPP was higher in MPCNL group in different stages of the procedure including introduction, fragmentation and end. However, only two trials were available for pooled analysis. Additionally, the risk of POF in MPCNL was 2.43 times higher than that in SPCNL [odds ratio (OR): 2.43, 95% CI: 1.39-4.27, P=0.002] with no significant between-study heterogeneity (P=0.83, I2=0%). ...Continue Reading

Citations

Nov 17, 2020·Current Opinion in Urology·Marco De SioDavide Arcaniolo
May 25, 2021·International Journal of Urology : Official Journal of the Japanese Urological Association·Kazumi TaguchiTakahiro Yasui

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