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Meta-Analysis
. 2024 Jan-Feb;50(1):7-19.
doi: 10.1590/S1677-5538.IBJU.2023.0373.

Comparing Balloon Dilation to Non-Balloon Dilation for Access in Ultrasound-Guided Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis

Meixuan Ding  1 , Kai Zhu  1   2 , Wenzhao Zhang  1   3 , Haichao Huang  2 , Bo Duan  2 , Jiaxin Zheng  2 , Huiqiang Wang  2 , Tao Wang  2 , Peide Bai  2 , Chen Bin  1   2
Affiliations
Meta-Analysis

Comparing Balloon Dilation to Non-Balloon Dilation for Access in Ultrasound-Guided Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis

Meixuan Ding et al. Int Braz J Urol. 2024 Jan-Feb.

Abstract

Purpose: This study aims to evaluate the safety and efficacy of ultrasound-guided balloon dilation compared to non-balloon dilation for percutaneous nephrolithotomy (PCNL).

Materials and methods: A systematic review and meta-analysis were conducted by searching PubMed, EMBASE, and the Cochrane Library. Results were filtered using predefined inclusion and exclusion criteria as described and meta-analysis was performed using Review Manager 5.4 software.

Results: A total of six studies involving 1189 patients who underwent PCNL were included. The meta-analysis results demonstrated that compared to non-balloon dilation, balloon dilation was associated with reduced haemoglobin drop [mean difference (MD) = -0.26, 95% CI = -0.40 ~ -0.12, P = 0.0002], decreased transfusion rate [odds ratio (OR) = 0.47, 95% CI = 0.24 ~ 0.92, P = 0.03], shorter tract establishment time (MD = -1.30, 95% CI = -1.87 ~ -0.72, P < 0.0001) and shorter operation time (MD = -5.23, 95% CI = -10.19 ~ -0.27, P = 0.04).

Conclusions: Overall, ultrasound-guided balloon dilatation offered several advantages in PCNL procedures. It facilitated faster access establishment, as evidenced by shorter access creation time. Additionally, it reduced the risk of kidney injury by minimizing postoperative haemoglobin drop and decreasing the need for transfusions. Moreover, it enhanced the efficiency of surgery by reducing the operation time. However, it is important to note that the quality of some included studies was subpar, as they did not adequately control for confounding factors that may affect the outcomes. Therefore, further research is necessary to validate and strengthen these findings.

Keywords: Angioplasty, Balloon; Kidney Calculi; Nephrolithotomy, Percutaneous.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1. Flow diagram summarizing the process of literature selection.
Figure 2
Figure 2. Forest plots showing the pooled results of (A) haemoglobin drop, (B) sensitivity analysis of haemoglobin drop, (C) transfusion rate, (D) complication rate, and (E) sensitivity analysis of complication rate.
Figure 3
Figure 3. Forest plots showing the pooled results of (A) stone free rate, (B) tract establishment time, (C) sensitivity analysis of tract establishment time, (D) operation time, (E) hospital stay, and (F) successful dilation rate.
See this image and copyright information in PMC

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