Comparative Outcomes of Day-case Percutaneous Nephrolithotomy Versus Conventional Inpatient Surgery: A Systematic Review and Meta-analysis
To conduct a systematic review and meta-analysis to evaluate the effectiveness and safety of PCNL performed as a day-case surgery in comparison to inpatient PCNL. Databases were searched up to January 27, 2024, for randomized and non-randomized studies comparing outcomes between day-case PCNL and in...
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Published in | Urology (Ridgewood, N.J.) |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Elsevier Inc
21.09.2024
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Online Access | Get full text |
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Summary: | To conduct a systematic review and meta-analysis to evaluate the effectiveness and safety of PCNL performed as a day-case surgery in comparison to inpatient PCNL.
Databases were searched up to January 27, 2024, for randomized and non-randomized studies comparing outcomes between day-case PCNL and inpatient PCNL. Pooled data were analyzed using a random-effects (RE) model when Higgins I2% heterogeneity values were >50%; otherwise, a fixed-effects model was employed. The results were reported as odds ratios (OR), mean difference (MD) or standardized MD (SMD) with 95% confidence intervals (CI). Statistical significance was set at P <.05.
One randomized controlled trial (RCT) and 14 observational studies totaling 1574 patients were included. Pooled results revealed that patients in the day-case PCNL group experienced reduced blood loss (SMD −0.71 95% CI: [−1.31, −0.12] P .02) and transfusion rates (OR 0.10 95% CI: [0.03, 0.39], P .0008), lower overall and minor complications (OR 0.56, 95% CI: [0.42, 0.76], P .0002, and OR 0.52, 95% CI: [0.37, 0-73], P .0002, respectively), shorter operative time (MD −11.46, 95% CI: [−17.41, −5-50], P <.00001), and reduced total costs (MD −1597.18, 95% CI [−2436.42, −757.93], P .0002). Major complications, stone-free rate (SFR), emergency department (ED) visits, and readmission rates were similar between the groups.
Day-case PCNL is a feasible and safe alternative to inpatient PCNL surgery in carefully selected patients, without increasing the risk of complications or readmission rates, and is likely to reduce total costs. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 |
ISSN: | 0090-4295 1527-9995 1527-9995 |
DOI: | 10.1016/j.urology.2024.09.036 |