Abstract
Background:
It has been demonstrated that ultrasound (US)-guided renal collecting system access during percutaneous nephrolithotomy (PCNL) is efficient and secure. The puncture success rate fell to 82%, and the total complication rate rose to 15% in kidneys with nondilated collecting systems. Contrast-enhanced ultrasonography (CEUS) has been used in PCNL techniques to address this issue.
Methods:
We did this meta-analysis following the preferred reporting criteria for systematic reviews and meta-analysis to combine the data of published studies to compare the CEUS-guided PCNL and the standard US-guided PCNL (PRISMA). For relevant literature, we searched PubMed, Embase, Web of Science, CKNI, and the Cochrane Library. The final inclusion date for this meta-analysis was May 1, 2022, and three randomized controlled trials (RCTs) were finally included. RevMan V5.4.1 was used in this work. Standard mean difference (SMD) with a 95% confidence interval (CI) was utilized as the major estimate in the synthesis of continuous data, while odds ratio (OR) with a 95% CI was synthesized as the main estimate in the synthesis of discontinuous data.
Results:
We found that compared with traditional US-guided PCNL, CEUS-guided PCNL could offer more benefits in terms of single-needle success rate (OR: 3.02, 95% CI: 1.62 to 5.61, p = 0.0005), shorter puncture time (SMD: −1.33, 95% CI: −2.06 to −0.60, p = 0.0004), shorter hospital stays (SMD: −0.37, 95% CI: −0.60 to −0.13, p = 0.002), and a better stone clearance rate (OR: 2.32, 95% CI: 1.15 to 4.68. p = 0.02). Although the PCNL complication rate after surgery was not significantly reduced by the CEUS technique (overall complication: OR = 0.70, 95% CI: 0.37 to 1.30, p = 0.25. Grade 1/2 complication: OR = 0.79, 95% CI: 0.41 to 1.53, p = 0.48; Grade 3/4 complication: OR = 0.44, 95% CI: 0.10 to 1.98, p = 0.28), it could reduce hemoglobin dropping compared with conventional US-guided PCNL (SMD: −0.82, 95% CI: −1.06 to −0.58, p < 0.001).
Conclusion:
The CEUS-guided PCNL technique is superior to the US-guided PCNL, according to almost all synthesized data. Additional randomized studies are still required.
Get full access to this article
View all access options for this article.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
