Abstract
Miniaturized percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for renal stones have been developed to overcome the invasive disadvantages of PCNL. We aimed to compare the therapeutic effect and safety of ultra-mini percutaneous nephrolithotomy (UMPCNL) and RIRS for renal stones using an updated systematic review and meta-analysis. We searched clinical trials comparing UMPCNL and RIRS for renal stones using the PubMed, EMBASE, Cochrane Library, and Google Scholar databases up to October 2021. Seven studies were included in the current study. The renal stone size was 10–20 mm in three studies, 10–25 mm in one study, 10–35 mm in two studies, and not specified in one study. The stone-free rate of UMPCNL was higher than that of RIRS (p = 0.02; odds ratio (OR) = 2.01; 95% confidence interval (CI) = 1.12, 3.61). The complication rate showed no significant difference between UMPCNL and RIRS (p = 0.48; OR = 1.20; 95% CI = 0.73, 1.98). Regarding the operative time, UMPCNL was shorter than RIRS (p = 0.005; weighted mean difference (WMD) = −15.63; 95% CI = −26.60, −4.67). The hospital stay of UMPCNL was longer than that of RIRS (p = 0.0004; WMD = 1.48; 95% CI = 0.66, 2.31). UMPCNL showed higher efficacy than RIRS and similar safety to RIRS. UMPCNL may be a useful therapeutic option for moderate-sized renal stones.
Highlights
Urolithiasis is becoming more common across the world
Five studies were performed in Europe [14,16–19]
The complication rate showed no significant difference between ultra-mini percutaneous nephrolithotomy (UMPCNL) and RIRS (p = 0.48; odds ratio (OR) = 1.20; 95% confidence interval (CI) = 0.73, 1.98; I2 = 0%) (Figure 4)
Summary
Urolithiasis is becoming more common across the world. In the United States, the overall prevalence of renal stones increased from 3.2% in 1980 to 10.1% in 2016 [1]. From 2000 to 2010, the hospital incidence of upper tract stones in the UK increased by 63% [2]. In Asia, the prevalence of urolithiasis has increased in recent decades (China and Japan: from 4% to 6.4% and from 4.3% to 9.0%, respectively) [3]. There has been an increased prevalence of urolithiasis in South Korea (from 3.5% to 11.5%) [4,5]. As a result, choosing the appropriate treatment for urolithiasis is critical for enhancing the quality of life and economic aspects of stone formers
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