Efficacy and safety of disposable ureteroscope and reusable ureteroscope in the treatment of upper urinary tract stones:a meta-analysis
Objective:To systematically review the efficacy and safety of single-use flexible ureteroscope(su-fURS)versus reusable flexible ureteroscope(ru-fURS)in the treatment of upper urinary tract stones.Methods:We systematically searched clinical research data comparing su-fURS and ru-fURS in the treatment of upper urina-ry tract stones in Pubmed,Embase,Cochrane Library,CNKI,Wanfang and Weipu databases,from the estab-lishment of the library to April 2023.Information and data from included studies were extracted and meta-analysis was performed using the statistical software Review Manager 5.3.Results:A total of 16 articles were included,including 2 121 patients,1 082 in the su-fURS group and 1 039 in the ru-fURS group.The results showed that there were no statistically significant differences between su-fURS and ru-fURS in the treatment of upper urinary tract stones in terms of the total effective rate of lithotripsy(OR=1.17,95％CI:0.94-1.46,P=0.16),the utilization rate of stone basket(OR=1.36,95％CI:0.82-2.26,P=0.23),postoperative hospital stay(OR=-0.04,95％CI:-0.15-0.06,P=0.44),preoperative double J tube indwelling rate(OR=1.00,95％CI:0.78-1.27,P=0.97),or postoperative Clavien Ⅰ-Ⅱ complication rate(OR=1.12,95％CI:0.81-1.54,P=0.49).However,the efficiency of su-fURS for lower renal calyceal calculi was higher than that of ru-fURS(OR=2.61,95％CI:1.34-5.07,P=0.005).Conclusion:The efficacy and safety of su-fURS and ru-fURS in the treatment of upper urinary tract stones are comparable,but su-fURS has a higher efficacy rate for lower renal calyceal calculi.Further high-quality studies are needed to validate this conclusion.
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