دورية أكاديمية
Feasibility, safety, and effectiveness of adult-sized instruments in pediatric percutaneous nephrolithotomy: A systematic review and meta-analysis.
| العنوان: | Feasibility, safety, and effectiveness of adult-sized instruments in pediatric percutaneous nephrolithotomy: A systematic review and meta-analysis. |
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| المؤلفون: | Soltani MH; Shahid Labbafinejad Hospital, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Karimi A; Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran., Salimi M; Shahid Labbafinejad Hospital, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Amini E; Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: amini.erfan@gmail.com. |
| المصدر: | Journal of pediatric urology [J Pediatr Urol] 2022 Jun; Vol. 18 (3), pp. 303-310. Date of Electronic Publication: 2022 Apr 22. |
| نوع المنشور: | Journal Article; Meta-Analysis; Review; Systematic Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: England NLM ID: 101233150 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4898 (Electronic) Linking ISSN: 14775131 NLM ISO Abbreviation: J Pediatr Urol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Kidlington, Oxford, UK : Elsevier, c2005- |
| مواضيع طبية MeSH: | Kidney Calculi*/surgery , Nephrolithotomy, Percutaneous*/adverse effects , Nephrolithotomy, Percutaneous*/methods , Nephrostomy, Percutaneous*/methods, Adult ; Child ; Feasibility Studies ; Humans ; Reproducibility of Results ; Retrospective Studies ; Treatment Outcome |
| مستخلص: | Introduction: Little evidence exists regarding the benefits and disadvantages of adult-sized instruments for Percutaneous Nephrolithotomy (PCNL) in pediatric patients. This systematic review aims to clarify the safety and efficacy of this approach. Materials and Methods: We conducted a systematic literature review using databases of PubMed, Scopus, Embase, Web of Science, and Cochrane and included studies that evaluated PCNL in children. All identified records underwent two-phase title/abstract and full-text screening. Pediatric patients were defined as 17 years or younger, and adult-sized instruments as 24Fr and above. The primary outcomes were success (stone-free) rate and surgical complications obtained from studies comparing adult-sized and pediatric-sized instruments. Results: A total of 84 abstracts and 16 full text article were assessed till July 2021 and 6 studies were included. All studies were retrospective. Number of accesses (Odds ratio (OR), adult-sized to pediatric-sized: 0.96, 95% CI: 0.52-1.78, p = 0.89), initial stone-free rate (OR: 0.73, 95% CI: 0.42-1.27, p = 0.26), final stone-free rate (OR: 1.14, 95% CI: 0.38-3.44, p = 0.82), and residual stones (OR: 0.79, 95% CI: 0.42-1.49, p = 0.46) could be analyzed, none with significant differences. Overall complication rates did not differ significantly between the groups. However, one study reported more grade III/IV complications in the adult-sized instrument group. The adult-sized instrument group had a higher hemoglobin/hematocrit decrease in 3 studies. Duration of surgery, fluoroscopy time, length of hospital stay, times to nephrostomy tube removal, and transfusion rate could not be assessed in meta-analysis; however, they were comparable between the adult-sized and pediatric-sized groups. Studies also showed that adult-sized instruments are applicable in children younger than 3 years and those with staghorn calculi as well as in fluoroscopy-free ultrasound-guided PCNL. Conclusion: Adult-sized instruments had comparable outcomes to the pediatric-sized ones and can be applied in pediatric PCNL when factors such as accessibility justify their use. The number and design of the studies restrict the reliability of the comparisons. Therefore, future studies with improved methodology may better reveal the impact of instruments on the outcome of PCNL in children. Competing Interests: Conflict of interest None. (Copyright © 2022 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Children; Nephrolithiasis; Percutaneous nephrolithotomy; Surgical instrument |
| تواريخ الأحداث: | Date Created: 20220509 Date Completed: 20220628 Latest Revision: 20220712 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1016/j.jpurol.2022.04.014 |
| PMID: | 35534382 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1873-4898 |
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| DOI: | 10.1016/j.jpurol.2022.04.014 |