Is Nonpapillary Puncture a Feasible Alternative to Papillary Access in Percutaneous Nephrolithotomy? A Systematic Review and Meta-Analysis.
Chengjian Ji, Ziheng Su, Xian Wu et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the safety and efficacy of nonpapillary versus papillary access in percutaneous nephrolithotomy (PCNL) among 1229 patients. The study found no significant differences in postoperative hemoglobin drop, complication rates, or stone-free rates between the two access methods. However, nonpapillary access was associated with a significantly shorter operative time in prospective studies (MD = -6.608, p = 0.0091).
Key findings
- No significant difference in postoperative hemoglobin drop between access methods (MD = 0.159, p = 0.5519).
- Overall complication rates were similar for both access types (RR = 0.949, p = 0.7371).
- Nonpapillary access showed a significantly shorter operative time in prospective studies (MD = -6.608, p = 0.0091).
- Stone-free rates were comparable between nonpapillary and papillary access (RR = 0.970, p = 0.3527).
Why it matters
Understanding the comparative safety and efficacy of different access methods in PCNL is crucial for optimizing patient outcomes. This study supports the flexibility in choosing access routes based on individual clinical scenarios, potentially improving surgical efficiency.