Efficacy And Safety Of The Single-tract And Multiple-tract Percutaneous Nephrolithotomy In The Treatment Of Complex Renal Calculi: A Meta-analysis

Objective:Systematical evaluation of the safety and efficacy of the single-tract and multiple-tract percutaneous nephrolithotomy in the treatment of complex renal calculi.Methods:Retrieve Pub Med?VIP?Wanfang and CNKI database through computer from1990 to September 2016,comprehensively collect the RCT and NRCT on the single-tract and multiple-tract percutaneous nephrolithotomy in the comparative treatment of complex renal calculi.According to the inclusion and exclusion criteria,the meta analysis was performed using Rev Man 5.3 software by 2 reviewers,after selecting the test,extracting the data and evaluating the quality.Results:13 studies and 2053 patients were included.The results of meta analysis show that: in multiple-tract group,stone-free rate was higher [OR=0.33,95%CI(0.22~0.52),P<0.00001],with less intra-operative bleeding [MD=10.53,95%CI(1.96~19.09),P=0.02],significantly decreased hemoglobin after operation [MD=10.30,95%CI(5.38~15.24),P=0.0006],more blood transfusion [OR=0.51,95%CI(0.35~0.75),P=0.0007] and higher post-operation complications incidence [OR=0.51,95%CI(0.36~0.72),P=0.0001];however,there was no statistical significance in the operation time,postoperative infection,hospitalization time and post-operative creatinine chang es(P>0.05).Conclusion:The advantages of multiple-tract percutaneous nephrolithotomy are higher stone-free rates,less intra-operative bleeding,etc;and its disadvantages are significantly decreased hemoglobin after operation more blood transfusion and post-operation complications,etc.