Urolithiasis
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Meta Analysis
Nephrolithiasis as a risk factor of chronic kidney disease: a meta-analysis of cohort studies with 4,770,691 participants.
The objective of the study was to investigate the association between nephrolithiasis and the risk of chronic kidney disease (CKD). PubMed, Embase and ScienceDirect databases were searched for relevant cohort studies. A meta-analysis was conducted by pooling data from these studies via an inverse variance method. ⋯ Publication bias was not detected. Sensitivity analysis indicated that the results were stable. Nephrolithiasis may increase the risk of CKD, regardless of the patient population (region), and may be an important risk factor for end-stage kidney disease.
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Review Meta Analysis Comparative Study
The efficacy and safety of percutaneous nephrolithotomy under general versus regional anesthesia: a systematic review and meta-analysis.
This meta-analysis was performed to evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL) under regional anesthesia (RA) vs. general anesthesia (GA). A systematic literature search in the electronic databases (Cochrane CENTRAL, Medline and EMBASE) was performed up to April 2014. Twelve trials, including 1954 patients, met the inclusion criteria and were included in the final analysis. ⋯ However, there was no difference between RA and GA groups with regard to stone-free rate (OR, 1.09; 95 % CI, 0.86-1.37) and postoperative complications associated with PCNL (OR, 0.95; 95 % CI 0.58-1.54). Our results show that PCNL under RA offers several potential advantages over GA in terms of surgical duration, hospitalization period, fluoroscopy time, blood transfusion, postoperative pain, and analgesic requirements, but both anesthetic techniques appear to be equivalent with regard to the stone-free rate and complication rate. Along with the suggested favorable hemodynamic profile and lower cost, RA may prove a better alternative than GA.
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Meta Analysis Comparative Study
Is the supine position superior to the prone position for percutaneous nephrolithotomy (PCNL)?
The objective of this study is to update the two previous meta-analyses in order to evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL) for patients in the prone position versus supine position. An electronic database search of MEDLINE, EMBASE, google scholar, and the Cochrane library was performed up to June, 2013. All studies comparing prone with supine position for PCNL were included. ⋯ Meta-analysis of extractable data showed that PCNL in the supine position was associated with a significantly shorter operative time (WMD: 21.7; 95% CI 2.46-40.94; p = 0.03) but lower stone-free rate (OR: 1.36; 95% CI 1.19-1.56; p < 0.0001) than PCNL in the prone position. There was no difference between the two positions regarding hospital stay (WMD = 0.05; 95% CI -0.16-0.25; p = 0.66) and complication rate (OR: 1.1; 95% CI 0.94-1.28; p = 0.24). In conclusion, the present study found different results from the two previous meta-analyses results regarding stone-free rate; PCNL in the supine position had a significantly lower stone-free rate than that in prone position.
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Meta Analysis
Terpene compound drug as medical expulsive therapy for ureterolithiasis: a meta-analysis.
The aim of this study is to investigate the efficacy of terpene compound drug (pinene, camphene, borneol, anethole, fenchone and cineol in olive oil) in facilitating spontaneous passage of ureteral calculi through meta-analysis of randomized controlled trials (RCT). Systematic literature search on MEDLINE, EMBASE, OVID, Science Direct, Proquest, Google scholar, Cochrane Library databases and reference list of related literatures were done without language restriction. RCTs on ureterolithiasis medical expulsive therapy (MET) that compare terpene compound drug versus placebo/control group or alpha-blockers were identified. ⋯ Only minor gastrointestinal adverse effect was reported on terpene compound drug use. The results suggest that terpene compound drug as MET is effective in augmenting spontaneous passage of ureterolithiasis. High quality large-scale RCTs comparing alpha-blockers and terpene compound drug are warranted to make a more definitive conclusion.