A Meta-analysis of Efficacy and Safety of Flexible Ureteroscopic Holmium Laser Lithotripsy Combined with Flexible Negative Pressure Aspiration Sheath versus Percutaneous Nephrolithotomy for 2-3 cm Upper Urinary Tract Calculi
Huo Zhongchao
Cheng Haifeng
He Yongzhi
Wang Lei
Ding Rui
Yang Jianqi
Zhao Wenting
Cai Zi
Kong Caiying
Gao Yiping
Abstract：Methods:Clinical studies on single-use flexible ureteroscopic holmium laser lithotripsy combined with flexible negative pressure aspiration sheath(combined group)versus PCNL(PCNL group)for upper urinary tract calculi,published from January 2010 to February 2025 at home and abroad,were retrieved.Data were extracted according to the Co-chrane systematic review method,and Meta-analysis was performed using RevMan 5.6 statistical software to compare indica-tors such as operation time,stone clearance rate,total complications,postoperative fever,postoperative hemoglobin de-cline,blood loss,and hospital stay between the two groups.Results:A total of 7 Chinese studies involving 994 patients(538 in the combined group and 456 in the PCNL group)were finally included in the Meta-analysis.There were no statistically sig-nificant differences in operation time(MD=6.43,95%CI:-6.56 to 19.42,P=0.33)or stone clearance rate(OR=1.24,95%CI:0.50 to 3.05,P=0.65)between the two groups.Compared with the PCNL group,the combined group had a lower incidence of total complications(MD=0.33,95%CI:0.23 to 0.48,P<0.001),a lower incidence of postoperative fever(OR=0.54,95%CI:0.30 to 1.00,P=0.05),a smaller postoperative hemoglobin decline(MD=-4.28,95%CI:-6.83 to-1.73,P=0.001),less blood loss(MD=-9.98,95%CI:-10.78 to-9.19,P<0.001),and a shorter hospital stay(MD=-2.25,95%CI:-3.21 to-1.30,P<0.001).Objective:To compare the efficacy and safety of single-use flexible ureteroscope combined with flexible negative pressure as-piration sheath in holmium laser lithotripsy versus percutaneous nephrolithotomy(PCNL)for upper urinary tract calculi(2-3 cm).Conclusion:The two surgical methods have similar effects in terms of operation time and stone clearance.Compared with PCNL,flexible negative pressure aspiration sheath combined with flexible ureteroscopic holmium laser lithotripsy has obvious advantages in postoperative fever,hospital stay,blood loss,total complication rate,and hemoglobin decline.
Keywords：percutaneous nephrolithotomyflexible negative pressure aspiration sheathflexible ureteroscopeupper urinary tract calculiMeta-analysis
Publication Date：2025-08-28
Online Publishing Date：2025-10-22(First online date of this platform, not the publication date of the document)
Pages：7( 238-244 )