Comparison the efficacy and safety of Tip-flexible suction ureteral access sheath and ordinary ureteral access sheath combined with flexible ureteroscopy to treat upper urinary tract stones:a meta-analysis
Objective To systematically evaluate of the efficacy and safety of Tip-flexible suction ureteral access sheath and ordinary ureteral access sheath combined with flexible ureteroscopy to treat upper urinary tract stones.Methods The databases CNKI,Wanfang,VIP,CBM,PubMed,Cochrane,Embase,Web of Science,MEDLINE and Google Scholar were searched from their inception to May 31,2024 for related studies about Tip-flexible suction ureteral access sheath compared with ordinary ureteral sheath combined with flexible ureteroscopy to treat upper urinary tract stones.Literature screening and data extraction were performed independently by two researchers,the quality assessment of randomized controlled trials was assessed using the Cochrane risk of bias assessment scale,the Newcastle-Ottawa risk of bias assessment scale was used to assess the quality of retrospective studies,and finally Meta-analysis of data was conducted using Review Manager 5.3 software.Results A total of 14 literatures involving 1947 patients with upper urinary tract stones(1017 in the Tip-flexible suction sheath group and 930 in the ordinary sheath group)were included.Meta-analysis showed that the stone free rate of the Tip-flexible suction sheath group was higher than that of the ordinary sheath group(immediate postoperative stone free rate 80.7％vs.60.0％,OR=3.04,95％CI2.30-4.03,P＜0.05;1 month after surgery stone free rate 94.4％vs.79.4％,OR=4.39,95％CI 3.12-6.19,P＜0.05).The total complication rate of the Tip-flexible suction sheath group was lower than that of the ordinary sheath group(5.4％vs.17.3％,OR=0.29,95％CI 0.21～0.40,P＜0.05).There was no significant difference in the decrease of hemoglobin level between the Tip-flexible suction sheath group and the ordinary sheath group at 1 day after surgery(MD=-0.30,95％CI-2.61-2.02,P＞0.05).The postoperative fever in the Tip-flexible suction sheath group was less than that in the ordinary sheath group(1.9％vs.7.5％,OR=0.28,95％CI 0.15-0.54,P＜0.05).There was no significant difference in operation time between the Tip-flexible suction sheath group and the ordinary sheath group(MD=-4.93,95％CI-11.48-1.62,P＞0.05).The postoperative hospital stay in the Tip-flexible suction sheath group was shorter than that in the ordinary sheath group(MD=-0.20,95％CI-0.25--0.16,P＜0.05).Conclusions Compared with ordinary ureteral access sheath combined with flexible ureteroscope to treat upper urinary tract stones,Tip-flexible suction ureteral access sheath has a higher stone free rate,less postoperative fever,low total complication rate,shorter postoperative hospital stay,which is conducive to postoperative recovery and is safer and more effective.
万方数据
维普
