Affiliation:
1. Department of Urology, Qilu Hospital of Shandong University
Abstract
Abstract
Objective To investigate the effectiveness and safety of ureteral access sheaths (UAS) in flexible ureteroscopic lithotripsy of upper urinary tract stones through a comprehensive systematic review and meta-analysis.Methods We conducted a meta-analysis and systematic review of the UAS in flexible ureteroscopy lithotripsy on April 12, 2023 (PROSPERO ID : CRD42022368459). The main outcomes of the meta-analysis included stone-free rate (SFR), intra and post-operation complications, hospitalization duration, and operation time.Results Twenty-one studies with 11335 patients satisfied the inclusion criteria. The results showed that compared with the UAS group, the non-UAS group had a higher stone-free rate(SFR) (OR = 0.76, 95%CI 0.60–0.95, P = 0.01) and shorter operation time(MD = 11.21, 95% CI 5.66–16.76, P < 0.00001), but no significant difference in postoperative complications(OR = 1.20, 95% CI 0.79–1.82, P = 0.38), intraoperative complications(OR = 1.20, 95%CI 0.85–1.70, P = 0.57), and hospitalization duration (MD = -0.03, 95%CI -0.30-0.24, P = 0.84).Conclusion Our findings indicate that UAS usage results in unfavorable surgical outcomes with no benefit in preventing surgical complications. Therefore, we recommend re-evaluating the usage of UAS as a surgical aid in patients with large stones.
Publisher
Research Square Platform LLC