The Results of Ureteral Stenting After Ureteroscopic Lithotripsy for Ureteral Calculi: A Systematic Review and Meta-Analysis

医学 泌尿系统 输尿管镜检查 支架 随机对照试验 碎石术 外科 入射(几何) 荟萃分析 下尿路症状 输尿管 科克伦图书馆 激光碎石术 内科学 前列腺 物理 癌症 光学
作者
Shen Peng-fei,Yutao Li,Jie Yang,Wuran Wei,Yi Dai,Hao Zeng,Jia Wang
出处
期刊:The Journal of Urology [Lippincott Williams & Wilkins]
卷期号:186 (5): 1904-1909 被引量:94
标识
DOI:10.1016/j.juro.2011.06.066
摘要

No AccessJournal of UrologyAdult Urology1 Nov 2011The Results of Ureteral Stenting After Ureteroscopic Lithotripsy for Ureteral Calculi: A Systematic Review and Meta-Analysis Shen Pengfei, Li Yutao, Yang Jie, Wei Wuran, Dai Yi, Zeng Hao, and Wang Jia Shen PengfeiShen Pengfei , Li YutaoLi Yutao , Yang JieYang Jie , Wei WuranWei Wuran , Dai YiDai Yi , Zeng HaoZeng Hao , and Wang JiaWang Jia View All Author Informationhttps://doi.org/10.1016/j.juro.2011.06.066AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the necessity and adverse effects of routine ureteral stent placement after ureteroscopic lithotripsy for ureteral stones. Materials and Methods: A systematic search of PubMed®, Embase® and the Cochrane Library was performed to identify all randomized controlled trials. All relevant studies were on the outcomes and complications of ureteroscopic lithotripsy in the management of ureteral stones with or without a Double-J stent. The outcomes and complications included stone-free rate, operative time, lower urinary tract symptoms, hematuria, fever, urinary tract infection, pain and analgesia, unplanned medical visits and late postoperative complications. The Cochrane Collaboration Review Manager software (RevMan 5.0.2) was used for statistical analysis. Results: A total of 16 randomized controlled trials were enrolled for analysis and involved 1,573 patients. Of these patients 797 were in the nonstented group and 776 in the stented group. There was a statistically significant difference in mean operative time between the 2 groups. The incidence of lower urinary tract symptoms and pain was significantly higher in the stented group than in the nonstented group. Significant differences between the groups were not found in fever, urinary tract infection, need for analgesia, unplanned readmission and late postoperative complications. Conclusions: This systematic review reveals the obvious disadvantages of ureteral stents after ureteroscopic lithotripsy in lower urinary tract symptoms and pain. Stents do not improve stone-free rate, fever, incidence of urinary tract infection, unplanned medical visits, requirement for analgesia and late postoperative complications. Ureteral stenting after uncomplicated ureteroscopic lithotripsy could be unnecessary. References 1 : Routine stenting after ureteroscopy: think again. Eur Urol2007; 52: 642. Google Scholar 2 : Is ureteral catheterization necessary after ureteroscopic lithotripsy for uncomplicated upper ureteral stones?. J Endourol2008; 22: 1645. Google Scholar 3 : The effect of ureteral stent placement on post-ureteroscopy complications: a meta-analysis. Urology2008; 71: 796. 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Google Scholar 17 : Ureteric stenting after ureteroscopy for ureteric stones: a prospective randomized study assessing symptoms and complications. BJU Int2004; 93: 1032. Google Scholar 18 : A prospective randomized multicentric study comparing stented vs non-stented ureteroscopic lithotripsy. Arch Ital Urol Androl2006; 78: 53. Google Scholar 19 : Stenting versus non-stenting after non-complicated ureteroscopic manipulation of stones in bilharzial ureters. Int J Urol2006; 13: 886. Google Scholar 20 : Is routine ureteral stenting necessary after uncomplicated ureteroscopic lithotripsy for lower ureteral stones larger than 1 cm?. Urol Res2008; 36: 115. Google Scholar 21 : Role of ureteral stenting after uncomplicated ureteroscopy for distal ureteral stones: a randomized, controlled trial. J Urol2008; 180: 961. Link, Google Scholar 22 : Nonstented versus routine stented ureteroscopic holmium laser lithotripsy: a prospective randomized trial. Urol Res2008; 36: 259. 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Google Scholar Department of Urology, West China Hospital, Sichuan University, Chengdu, China© 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byHiller S, Daignault-Newton S, Rakic I, Linsell S, Conrado B, Jafri S, Rubenstein R, Abdelhady M, Fischer C, Gimenez E, Sarle R, Roberts W, Maitland C, Yousif R, Elgin R, Galejs L, Konheim J, Leavitt D, Stockall E, Fontera J, Wolf J, Hollingsworth J, Dauw C and Ghani K (2022) Appropriateness Criteria for Ureteral Stent Omission following Ureteroscopy for Urinary Stone DiseaseUrology Practice, VOL. 9, NO. 3, (253-263), Online publication date: 1-May-2022.Stern K (2021) Editorial CommentJournal of Urology, VOL. 205, NO. 6, (1717-1717), Online publication date: 1-Jun-2021.Pais V, Smith R, Stedina E and Rissman C (2016) Does Omission of Ureteral Stents Increase Risk of Unplanned Return Visit? A Systematic Review and Meta-AnalysisJournal of Urology, VOL. 196, NO. 5, (1458-1466), Online publication date: 1-Nov-2016. Volume 186Issue 5November 2011Page: 1904-1909 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsureteral calculilithotripsystentsreview [publication type]MetricsAuthor Information Shen Pengfei More articles by this author Li Yutao More articles by this author Yang Jie More articles by this author Wei Wuran More articles by this author Dai Yi More articles by this author Zeng Hao More articles by this author Wang Jia More articles by this author Expand All Advertisement PDF downloadLoading ...
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