The Clinical Efficacy of Percutaneous Nephrolithotomy and Flexible Ureteroscopic Lithotripsy in the Treatment of Calyceal Diverticulum Stones: A Meta-Analysis

Abstract

Background: The clinical efficacy of percutaneous nephrolithotomy (PCNL) and flexible ureteroscopic lithotripsy (FURL) in the treatment of calyceal diverticulum stones (CDs) remains controversial. We performed a meta-analysis to assess the clinical efficacy of PCNL and FURL in the treatment of CDs. Methods: We searched a number of relevant electronic databases including China National Knowledge Infrastructure (CNKI), MEDLINE, PubMed, Web of Science, EMBASE, and Cochrane Library until January 31, 2022. STATA 15.1 software was used to analyze all data for this article. The quality of these studies was assessed by the Newcastle-Ottawa Scale (ranged from 0 to 9 stars). Results: Finally, we selected 11 high-quality studies in our meta-analysis,which containing 486 patients. Meta-analysis showed that PCNL had higher stone-free rate [OR=3.55, 95% CI: 2.07 -6.10, P = 0.000], symptom-free rate [OR=3.56, 95% CI: 1.51 -8.38, p= 0.004], while it was slightly inferior to the FURL in bleeding volume [SMD = 1.27, 95% CI: (0.67,1.87), P = 0.000], hospital stay [SMD =2.86, 95% CI: 1.75-3.97, P = 0.000] and complication rate [OR =1.92, 95% CI: 1.10-3.33, P = 0.021], and there was no significant difference in operative time [SMD = -0.011, 95% CI: (-0.41,0.39), P = 0.957]. Conclusion: PCNL is safe and effective in the treatment of CDs, which can be considered as the first choice for the clinical treatment of CDs.