Meta-analysis Of Percutaneous Nephrolithotomy Periodic Treat For Calculous Pyonephrosis

Objective:To compare the percutaneous nephrolithotomy with stage I and stage II treatment of calculus pyonephrosis,the effectiveness,safety,economic benefit and post-operative complications of the two surgical treatment modes were systematically evaluated by this comparison.Methods:Searching for the English and Chinese literature on the treatment of calculus pyonephrosis by periodic percutaneous nephrolithotomy by through the computer to search PubMed、Medline、Web of Science、Corchrane library,Wanfang,Weipu,China Biomedical Literature System,CNKI and other databases.The time limit is for the construction of the warehouse until March 2019.The literature was screened in strict accordance with the set exclude and include standards,and the quality of the literature was evaluated.Relevant data were extracted,then using RevMan5.3 software for meta-analysis.Results:1.The basic information of the literature included: This study finally includ-ed 8Chinese literatures,The total number of patients enrolled was 532,o-f which 267 csaes were in stage I percutaneous nephrolithotomy,and 265 cas-es were i-n stage II.2.Stone clearance:There was no significant difference in the stone clearance rate between the stage I group and the stage II group(OR=0.79,95%CI(0.49,1.28),P=0.34).3.Mean operative time:There was no significant difference in the operation time between the I stage and the II stage(WMD=0.42,95%CI(-8.49,9.32),P=0.93).4.Hospitalization time:Compared with stage II group,the hospitalization time in the stageI group was shorter(WMD=-4.69,95%CI(-6.10,-3.28),P<0.00001).5.Hospital expenses:The hospital expenses of the stage I surgery group is less than that of the stage II surgery group(WMD=-0.69,95%CI(-0.86,-0.51),P<0.00001).6.Renal fistula retention time:the stage I surgery group was shorter than that in the stage II surgery group(WMD=-4.85,95%CI(-6.75,-2.96),P<0.00001).7.Complications after operation:The incidence of postoperative fever in st-age I surgery group was higher than that in stage II surgery group(OR=1.99,95%CI(1.22,3.25),P=0.006),There was no significant difference in the inc-idence of postoperat-ive septic shock and postoperative perirenal effusion infecti-on between the two groups.Respectively(OR=0.99,95%CI(0.46,2.13),P=0.98),(OR=1.57,95%CI(0.51,4.90),P=0.43).Conclusious:1.The percutaneous nephrolithotomy with calculus pyonephrosis in stage I has a higher incidence of postoperative fever,but it can reduce the hospital expenses and hospital stay,and also reduce the retention time of renal fistula.In addition,compared with the percutaneous nephrolithotomy in stage II,the incidence of stone clearance,operative time,postoperative septic shock and perirena-l effusion infection were comparable.2.For the treatment of calculus pyonephrosis,the percutaneous nephrolithot-omy in stage I is similar in effectiveness and safety to the stage II operation,and can also reduce the hospitalization time and hospital expenses.