A Meta-Analysis Of Tubeless And Standard Percutaneous Nephrostolithotomy

Objective : To systematically review the advantage of tubeless percutaneous nephrolithotomy.Methods :To retrieve Randomized controlled trials (RCTs) of tubeless and standard percutaneous nephrolithotomy, and investigate reference documents of literatures included. Data analyses of literatures which consistent with included standard were performed with the Cochrane ColLaboration's RevMan 5.0 software.Results :Seven literatures were retrieved, all RCTs,including 1605 patients, done Meta-analysis. The Meta-analysis results showed that compared with control group,patients in test group:(1) there was no significant difference between the two ways with Mean operation time,change of hemoglobin and post-operation infection(95% confidence interval,-15.16 to 0.13,P=0.05; 95% confidence interval -0.16 to 0.19,P=0.90;95% confidence interval 0.41 to 1.87.p=0.74);(2) shorten the hospital stays by 23.86h on average(95% confidence interval ,-32.35 to -15.36,P<0.00001);(3) decrease the postoperative analgesics dose by 69.02mg(95% confidence interval,-107.67 to -30.36,P<0.00001);and(4)remarkable improve the stone-free rate (95% confidence interval, 1.25 to 2.95,P<0.003).Conclusion : Our results show that tubeless percutaneous nephrolithotomy shorten the hospital stays, decrease the postoperative analgesics dose and improve the stone-free rate, which was significantly superior to standard percutaneous nephrolithotomy, and there was no significant difference between the two ways with Mean operation time,change of hemoglobin,and post-operation infection. Because of few studies and small samples,more high quality trials with large samples and longer following—up are proposed.