Comparison of vacuum-assisted sheaths and normal sheaths in minimally invasive percutaneous nephrolithotomy: a systematic review and meta-analysis

Abstract Background A systematic review and meta-analysis was conducted to compare the safety and efficacy of vacuum-assisted sheaths and conventional sheaths in minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of nephrolithiasis. Methods PubMed, Web of Science, Embase, EBSCO...

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Autores principales:	Ling Zhu, Zhenghao Wang, Ye Zhou, Liping Gou, Yan Huang, Xiaofeng Zheng
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Nephrolithiasis Minimally invasive percutaneous nephrolithotomy Vacuum-assisted sheath Conventional sheath Meta-analysis Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/6c5e2d4ac8e345899143e53e6f6d088b
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spelling	oai:doaj.org-article:6c5e2d4ac8e345899143e53e6f6d088b2021-11-21T12:31:02ZComparison of vacuum-assisted sheaths and normal sheaths in minimally invasive percutaneous nephrolithotomy: a systematic review and meta-analysis10.1186/s12894-021-00925-11471-2490https://doaj.org/article/6c5e2d4ac8e345899143e53e6f6d088b2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12894-021-00925-1https://doaj.org/toc/1471-2490Abstract Background A systematic review and meta-analysis was conducted to compare the safety and efficacy of vacuum-assisted sheaths and conventional sheaths in minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of nephrolithiasis. Methods PubMed, Web of Science, Embase, EBSCO, and Cochrane Library databases (updated March 2021) were used to search for studies assessing the effect of vacuum-assisted sheaths in patients who underwent MPCNL. The search strategy and study selection processes were implemented in accordance with the PRISMA statement. Result Three randomized controlled trials and two case-controlled trials that satisfied the inclusion criteria were enrolled in this meta-analysis. Overall, the stone-free rate (SFR) in patients who underwent vacuum-assisted sheaths was significantly higher than that in patients who underwent conventional sheaths (RR 1.23, 95% CI 1.04, 1.46, P = 0.02), with significant heterogeneity among the studies (I2 = 72%, P = 0.03). In terms of the outcome of complications, vacuum-assisted sheath could bring a benefit to the postoperative infection rate (RR 0.48, 95% CI 0.33, 0.70, P < 0.00001) with insignificant heterogeneity among the studies (I2 = 0%, P = 0.68). There was no significant difference in the blood transfusion rate (RR 0.35, 95% CI 0.07, 1.73, P = 0.17), with significant heterogeneity (I2 = 66%, P = 0.35). Three studies contained operative time data, and the results indicated that the vacuum-assisted sheath led to a shorter operative time (MD = − 15.74; 95% CI − 1944, − 12.04, P < 0.00001) with insignificant heterogeneity (I2 = 0%, P = 0.91). Conclusion The application of a vacuum-assisted sheath in MPCNL improves the safety and efficiency compared to the conventional sheath. A vacuum-assisted sheath significantly increases the SFR while reducing operative time and postoperative infection.Ling ZhuZhenghao WangYe ZhouLiping GouYan HuangXiaofeng ZhengBMCarticleNephrolithiasisMinimally invasive percutaneous nephrolithotomyVacuum-assisted sheathConventional sheathMeta-analysisDiseases of the genitourinary system. UrologyRC870-923ENBMC Urology, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Nephrolithiasis Minimally invasive percutaneous nephrolithotomy Vacuum-assisted sheath Conventional sheath Meta-analysis Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Nephrolithiasis Minimally invasive percutaneous nephrolithotomy Vacuum-assisted sheath Conventional sheath Meta-analysis Diseases of the genitourinary system. Urology RC870-923 Ling Zhu Zhenghao Wang Ye Zhou Liping Gou Yan Huang Xiaofeng Zheng Comparison of vacuum-assisted sheaths and normal sheaths in minimally invasive percutaneous nephrolithotomy: a systematic review and meta-analysis
description	Abstract Background A systematic review and meta-analysis was conducted to compare the safety and efficacy of vacuum-assisted sheaths and conventional sheaths in minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of nephrolithiasis. Methods PubMed, Web of Science, Embase, EBSCO, and Cochrane Library databases (updated March 2021) were used to search for studies assessing the effect of vacuum-assisted sheaths in patients who underwent MPCNL. The search strategy and study selection processes were implemented in accordance with the PRISMA statement. Result Three randomized controlled trials and two case-controlled trials that satisfied the inclusion criteria were enrolled in this meta-analysis. Overall, the stone-free rate (SFR) in patients who underwent vacuum-assisted sheaths was significantly higher than that in patients who underwent conventional sheaths (RR 1.23, 95% CI 1.04, 1.46, P = 0.02), with significant heterogeneity among the studies (I2 = 72%, P = 0.03). In terms of the outcome of complications, vacuum-assisted sheath could bring a benefit to the postoperative infection rate (RR 0.48, 95% CI 0.33, 0.70, P < 0.00001) with insignificant heterogeneity among the studies (I2 = 0%, P = 0.68). There was no significant difference in the blood transfusion rate (RR 0.35, 95% CI 0.07, 1.73, P = 0.17), with significant heterogeneity (I2 = 66%, P = 0.35). Three studies contained operative time data, and the results indicated that the vacuum-assisted sheath led to a shorter operative time (MD = − 15.74; 95% CI − 1944, − 12.04, P < 0.00001) with insignificant heterogeneity (I2 = 0%, P = 0.91). Conclusion The application of a vacuum-assisted sheath in MPCNL improves the safety and efficiency compared to the conventional sheath. A vacuum-assisted sheath significantly increases the SFR while reducing operative time and postoperative infection.
format	article
author	Ling Zhu Zhenghao Wang Ye Zhou Liping Gou Yan Huang Xiaofeng Zheng
author_facet	Ling Zhu Zhenghao Wang Ye Zhou Liping Gou Yan Huang Xiaofeng Zheng
author_sort	Ling Zhu
title	Comparison of vacuum-assisted sheaths and normal sheaths in minimally invasive percutaneous nephrolithotomy: a systematic review and meta-analysis
title_short	Comparison of vacuum-assisted sheaths and normal sheaths in minimally invasive percutaneous nephrolithotomy: a systematic review and meta-analysis
title_full	Comparison of vacuum-assisted sheaths and normal sheaths in minimally invasive percutaneous nephrolithotomy: a systematic review and meta-analysis
title_fullStr	Comparison of vacuum-assisted sheaths and normal sheaths in minimally invasive percutaneous nephrolithotomy: a systematic review and meta-analysis
title_full_unstemmed	Comparison of vacuum-assisted sheaths and normal sheaths in minimally invasive percutaneous nephrolithotomy: a systematic review and meta-analysis
title_sort	comparison of vacuum-assisted sheaths and normal sheaths in minimally invasive percutaneous nephrolithotomy: a systematic review and meta-analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/6c5e2d4ac8e345899143e53e6f6d088b
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Comparison of vacuum-assisted sheaths and normal sheaths in minimally invasive percutaneous nephrolithotomy: a systematic review and meta-analysis

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