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Meta-Analysis
. 2025 Jan 2;25(1):1.
doi: 10.1186/s12894-024-01655-w.

Percutaneous nephroscopy versus flexible ureteroscopy in the treatment of calyceal diverticulum calculi: a meta-analysis

Conglei Hu  1 , Rui Ma  2 , Yongxiang Shao  1 , Zilong Liang  1   3 , Meng Cheng  1 , Haofeng Pang  1   3 , Liping Yao  4 , Fei Liu  5
Affiliations
Meta-Analysis

Percutaneous nephroscopy versus flexible ureteroscopy in the treatment of calyceal diverticulum calculi: a meta-analysis

Conglei Hu et al. BMC Urol. .

Abstract

Background: There is still controversy about the best minimally invasive surgical method for the treatment of calyceal diverticulum calculi. We conducted meta-analysis to evaluate the effectiveness and safety of PCNL and FURL in the treatment of calyceal diverticulum calculi.

Methods: We searched Pubmed, Cochrane Library, Web of Science, Embase, Clinical trial platform, CNKI, VIP until April 2024. We utilized the Newcastle-Ottawa Scale (NOS, 0 to 9 stars) to assess the quality of the included literature.

Results: Totally 15 high-quality studies with 755 patients were included in the meta-analysis. Meta-analysis showed that FURL group was better than PCNL group in blood loss [SMD = 1.713, 95%CI:(0.858, 2.568), Z = 3.928, P = 0.000] and hospital stay [SMD = 2.611, 95%CI: (1.726, 3.496), Z = 5.784, P = 0.000], there was no significant difference in operating time [SMD = 0.079, 95%CI:(-0.43, 0.589), Z = 0.306, P = 0.760], complication rate [OR = 1.793,95%CI: (0.952,2.602), Z = 1.586, P = 0.113], stone-free rate [OR = 1.339, 95%CI: (0.576, 3.112), Z = 0.678, P = 0.497] and symptom-free rate [OR = 3.826,95%CI: (0.561,10.238), Z = 0.966, P = 0.334] as well.

Conclusion: Whether FURL is indeed superior to PCNL in safety, whether FURL's efficacy is really close to PCNL, and whether FURL can surpass PCNL as the first choice for the treatment of renal diverticulum stones in the future need to be further verified by multi-center, large-sample and high-quality studies.

Keywords: Calyceal diverticulum calculi; Flexible ureteroscopic lithotripsy; Meta-analysis; Percutaneous nephrolithotomy; Retrograde intrarenal surgery.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Since this study is a secondary study, all ethical approvals were provided by the initial study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of articles retrieval
Fig. 2
Fig. 2
Forest plot showing pooled SMD with 95% CI of operation time
Fig. 3
Fig. 3
Forest plot showing pooled SMD with 95% CI of blood loss
Fig. 4
Fig. 4
Forest plot showing pooled SMD with 95% CI of hospital stay
Fig. 5
Fig. 5
Forest plot showing pooled OR with 95% CI of complication rate. A Forest plot of complication rate; B Forest plot of sensitive analysis
Fig. 6
Fig. 6
Forest plot showing pooled OR with 95% CI of stone-free rate
Fig. 7
Fig. 7
Forest plot showing pooled OR with 95% CI of symptom-free rate. A Forest plot of symptom-free rate; B Forest plot of sensitive analysis
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