Meta-analysis Of Suction Sheath In Minimally Invasive Percutaneous Nephrolithotomy

Objective: This aim of study was to conduct a meta-analysis to assess the safety and effectiveness of SAS and TAS in MPCNL.Methods:We conducted a search of Pubmed、Medline(EBSCO)、Web of Science 、 Sinomed 、 Cochrane Central Register of Controlled Trials up to December 2020 for studies that compared the safety and effectiveness of SAS and TAS in MPCNL.The quality of retrospective case control studies(RCC)and randomized controlled trials(RCT)were assessed by the Newcastle-Ottawa Scale(NOS)and the Cochrane risk of bias tool.The Oxford centre set up evidence-based medicine to assess the level of evidence(LE).A standard meta-analysis used to assessed the interested indicators.Results:Seven databases,a total of 1655 patients,were included.Co mpared with the TAS group,the SAS group had a shorter operative time(mean difference [MD]=-17.30;95%confidence interval[95%CI][-23.09,-11.51];P<0.00001),better stone-free rate(odds ratio [OR]=2.37;95%CI[1.56,3.61];P<0.0001),fewer total complication rate(OR=0.50;95%CI[0.35,0.70];P<0.0001),lower auxiliary procedures rate(OR=0.48;95%CI[0.36,0.64];P<0.00001),lower postoperative fever rate(OR=0.46;95%CI[0.34,0.62];P<0.00001).Conclusion: Our meta-analysis conclusion indicates that the use of aspiration channel sheath in minimally invasive percutaneous nephrolithotomy can significantly reduce the operation time,total complication rate,postoperative fever rate and adjuvant treatment rate,and improve the rate of primary stone clearance compared with traditional channels.Compared with the sheath,it has better efficacy and safety.