Upotreba omotača za pristup ureteru tokom ureteroskopije: sistematski pregled i meta-analiza.
PloS one
Sažetak istraživanja
Još uvijek traje debata o korisnosti mokraćovodnog pristupnog omotača (UAS). Stoga je urađena meta-analiza kako bi se raspravljalo o efektima primjene UAS tokom ureteroskopije. Protokol za pregled je dostupan na PROSPERO (CRD42017052327). Pretraživanje literature obavljeno je do novembra 2017. koristeći Web of Science, PUBMED, EMBASE i Cochrane Library. Kvaliteta članaka ocjenjivana je Jadad skalom i Newcastle Ottawa skalom (NOS). Eggerov test i metoda trim-and-fill korišteni su za procjenu pristranosti publikacije. Veličine efekata izračunate su omjerom šansi (OR) i srednjim razlikama (MD). Izvršene su analize osjetljivosti i analize podgrupa kako bi se istražilo porijeklo heterogenosti. Identificirano je osam studija sa ukupno 3099 pacijenata i 3127 procedura.
Rezultati nisu pokazali značajnu razliku u stopi bez kamenca (SFR) (OR = 0,83, 95% CI 0,52-1,33, P = 0,45), intraoperativnim komplikacijama (OR = 1,16, 95% CI 0,81-7,69, P = 0,88), 45% CI (MD, 95%) (09%). -15,08-23,26, P = 0,68) i trajanje hospitalizacije (MD = -0,13, 95% CI -0,32-0,06, P = 0,18). Međutim, incidencija postoperativnih komplikacija bila je veća u grupi UAS (OR = 1,46, 95% CI 1,06-2,00, P = 0,02). Dokazi iz meta-analize pokazuju da upotreba UAS-a tokom ureteroskopije nije pokazala prednosti. Međutim, s obzirom na intrinzična ograničenja kvaliteta odabranih članaka, opravdano je više randomiziranih kontroliranih ispitivanja (RCT) kako bi se ažurirali nalazi ove analize.
Prikaži originalni naslov i sažetak na engleskom
Use of the ureteral access sheath during ureteroscopy: A systematic review and meta-analysis.
The debate still rages on for the usefulness of ureteral access sheath (UAS). Therefore, a meta-analysis to discuss the effects of applying UAS during ureteroscopy was performed. The protocol for the review is available on PROSPERO (CRD42017052327). A literature search was conducted up to November, 2017 using the Web of science, PUBMED, EMBASE and Cochrane Library. The quality of articles was assessed by the Jadad scale and Newcastle Ottawa Scale (NOS). Egger's test and the trim-and-fill method were used to evaluate publication bias. Effect sizes were calculated by pooled odds ratio (ORs) and mean differences (MDs). Sensitivity analyses and subgroup analyses were performed to explore the origin of heterogeneity. Eight trials with a total of 3099 patients and 3127 procedures were identified.
Results showed no significant difference in stone-free rate (SFR) (OR = 0.83, 95% CI 0.52-1.33, P = 0.45), intraoperative complications (OR = 1.16, 95% CI 0.81-7.69, P = 0.88), operative time (MD = 4.09, 95% CI -15.08-23.26, P = 0.68) and hospitalization duration (MD = -0.13, 95% CI -0.32-0.06, P = 0.18). However, the incidence of postoperative complications was higher in UAS group (OR = 1.46, 95% CI 1.06-2.00, P = 0.02). Evidence from meta-analysis indicated that the use of UAS during ureteroscopy did not manifest advantages. However, given the intrinsic restrictions of the quality of selected articles, more randomized controlled trials (RCTs) are warranted to update the findings of this analysis.
Izvorni podaci
- DOI
- 10.1371/journal.pone.0193600
- PMID
- 29489912
- PMCID
- PMC5831629
- Provjereno
- 2026-07-26
Naslov i sažetak prevedeni su automatski i prijevod može sadržavati netačnosti ili neprecizne stručne izraze. Za sve detalje, citiranje i medicinsko tumačenje pregledajte originalnu englesku verziju članka. Ne donosite zdravstvene odluke samo na osnovu ovog prijevoda.
Pregledaj originalni članak na engleskom