Nephrostomy tube versus double J ureteral stent in patients with malignant ureteric obstruction. A systematic review and meta-analysis of comparative studies
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | International Braz J Urol (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382022000600903 |
Resumo: | ABSTRACT Purpose: We aimed to perform a systematic review to assess perioperative outcomes, complications, and survival in studies comparing ureteral stent and percutaneous nephrostomy in malignant ureteral obstruction. Materials and Methods: This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Meta-analyses were performed on procedural data; outcomes; complications (device-related, accidental dislodgement, febrile episodes, unplanned device replacement), dislodgment, and overall survival. Continuous variables were pooled using the inverse variance of the mean difference (MD) with a fixed effect, and 95% confidence interval (CI). The incidences of complications were pooled using the Cochran-Mantel-Haenszel method with the random effect model and reported as Odds Ratio (OR), and 95% CI. Statistical significance was set two-tail p-value <0.05 Results: Ten studies were included. Procedure time (MD −10.26 minutes 95%CI −12.40-8.02, p<0.00001), hospital stay (MD −1.30 days 95%CI −1.69 − −0.92, p<0.0001), number of accidental tube dislodgments (OR 0.25 95% CI 0.13 – 0.48, p<0.0001) were significantly lower in the stent group. No difference was found in mean fluoroscopy time, decrease in creatinine level post procedure, overall number of complications, interval time between the change of tubes, number of febrile episodes after diversion, unplanned device substitution, and overall survival. Conclusion: Our meta-analysis favors stents as the preferred choice as these are easier to maintain and ureteral stent placement should be recommended whenever feasible. If the malignant obstruction precludes a stent placement, then PCN is a safe alternative. |
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Nephrostomy tube versus double J ureteral stent in patients with malignant ureteric obstruction. A systematic review and meta-analysis of comparative studiesUreteral ObstructionNephrostomy, PercutaneousUrinary DiversionABSTRACT Purpose: We aimed to perform a systematic review to assess perioperative outcomes, complications, and survival in studies comparing ureteral stent and percutaneous nephrostomy in malignant ureteral obstruction. Materials and Methods: This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Meta-analyses were performed on procedural data; outcomes; complications (device-related, accidental dislodgement, febrile episodes, unplanned device replacement), dislodgment, and overall survival. Continuous variables were pooled using the inverse variance of the mean difference (MD) with a fixed effect, and 95% confidence interval (CI). The incidences of complications were pooled using the Cochran-Mantel-Haenszel method with the random effect model and reported as Odds Ratio (OR), and 95% CI. Statistical significance was set two-tail p-value <0.05 Results: Ten studies were included. Procedure time (MD −10.26 minutes 95%CI −12.40-8.02, p<0.00001), hospital stay (MD −1.30 days 95%CI −1.69 − −0.92, p<0.0001), number of accidental tube dislodgments (OR 0.25 95% CI 0.13 – 0.48, p<0.0001) were significantly lower in the stent group. No difference was found in mean fluoroscopy time, decrease in creatinine level post procedure, overall number of complications, interval time between the change of tubes, number of febrile episodes after diversion, unplanned device substitution, and overall survival. Conclusion: Our meta-analysis favors stents as the preferred choice as these are easier to maintain and ureteral stent placement should be recommended whenever feasible. If the malignant obstruction precludes a stent placement, then PCN is a safe alternative.Sociedade Brasileira de Urologia2022-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382022000600903International braz j urol v.48 n.6 2022reponame:International Braz J Urol (Online)instname:Sociedade Brasileira de Urologia (SBU)instacron:SBU10.1590/s1677-5538.ibju.2022.0225info:eu-repo/semantics/openAccessGauhar,VineetPirola,Giacomo MariaScarcella,SimoneAngelis,Maria Vittoria DeGiulioni,CarloRubilotta,EmanueleGubbiotti,MarilenaLim,Ee JeanLaw,Yu Xi TerenceWroclawski,Marcelo LangerTiong,Ho YeeCastellani,Danieleeng2022-11-08T00:00:00Zoai:scielo:S1677-55382022000600903Revistahttp://www.brazjurol.com.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||brazjurol@brazjurol.com.br1677-61191677-5538opendoar:2022-11-08T00:00International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU)false |
dc.title.none.fl_str_mv |
Nephrostomy tube versus double J ureteral stent in patients with malignant ureteric obstruction. A systematic review and meta-analysis of comparative studies |
title |
Nephrostomy tube versus double J ureteral stent in patients with malignant ureteric obstruction. A systematic review and meta-analysis of comparative studies |
spellingShingle |
Nephrostomy tube versus double J ureteral stent in patients with malignant ureteric obstruction. A systematic review and meta-analysis of comparative studies Gauhar,Vineet Ureteral Obstruction Nephrostomy, Percutaneous Urinary Diversion |
title_short |
Nephrostomy tube versus double J ureteral stent in patients with malignant ureteric obstruction. A systematic review and meta-analysis of comparative studies |
title_full |
Nephrostomy tube versus double J ureteral stent in patients with malignant ureteric obstruction. A systematic review and meta-analysis of comparative studies |
title_fullStr |
Nephrostomy tube versus double J ureteral stent in patients with malignant ureteric obstruction. A systematic review and meta-analysis of comparative studies |
title_full_unstemmed |
Nephrostomy tube versus double J ureteral stent in patients with malignant ureteric obstruction. A systematic review and meta-analysis of comparative studies |
title_sort |
Nephrostomy tube versus double J ureteral stent in patients with malignant ureteric obstruction. A systematic review and meta-analysis of comparative studies |
author |
Gauhar,Vineet |
author_facet |
Gauhar,Vineet Pirola,Giacomo Maria Scarcella,Simone Angelis,Maria Vittoria De Giulioni,Carlo Rubilotta,Emanuele Gubbiotti,Marilena Lim,Ee Jean Law,Yu Xi Terence Wroclawski,Marcelo Langer Tiong,Ho Yee Castellani,Daniele |
author_role |
author |
author2 |
Pirola,Giacomo Maria Scarcella,Simone Angelis,Maria Vittoria De Giulioni,Carlo Rubilotta,Emanuele Gubbiotti,Marilena Lim,Ee Jean Law,Yu Xi Terence Wroclawski,Marcelo Langer Tiong,Ho Yee Castellani,Daniele |
author2_role |
author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Gauhar,Vineet Pirola,Giacomo Maria Scarcella,Simone Angelis,Maria Vittoria De Giulioni,Carlo Rubilotta,Emanuele Gubbiotti,Marilena Lim,Ee Jean Law,Yu Xi Terence Wroclawski,Marcelo Langer Tiong,Ho Yee Castellani,Daniele |
dc.subject.por.fl_str_mv |
Ureteral Obstruction Nephrostomy, Percutaneous Urinary Diversion |
topic |
Ureteral Obstruction Nephrostomy, Percutaneous Urinary Diversion |
description |
ABSTRACT Purpose: We aimed to perform a systematic review to assess perioperative outcomes, complications, and survival in studies comparing ureteral stent and percutaneous nephrostomy in malignant ureteral obstruction. Materials and Methods: This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Meta-analyses were performed on procedural data; outcomes; complications (device-related, accidental dislodgement, febrile episodes, unplanned device replacement), dislodgment, and overall survival. Continuous variables were pooled using the inverse variance of the mean difference (MD) with a fixed effect, and 95% confidence interval (CI). The incidences of complications were pooled using the Cochran-Mantel-Haenszel method with the random effect model and reported as Odds Ratio (OR), and 95% CI. Statistical significance was set two-tail p-value <0.05 Results: Ten studies were included. Procedure time (MD −10.26 minutes 95%CI −12.40-8.02, p<0.00001), hospital stay (MD −1.30 days 95%CI −1.69 − −0.92, p<0.0001), number of accidental tube dislodgments (OR 0.25 95% CI 0.13 – 0.48, p<0.0001) were significantly lower in the stent group. No difference was found in mean fluoroscopy time, decrease in creatinine level post procedure, overall number of complications, interval time between the change of tubes, number of febrile episodes after diversion, unplanned device substitution, and overall survival. Conclusion: Our meta-analysis favors stents as the preferred choice as these are easier to maintain and ureteral stent placement should be recommended whenever feasible. If the malignant obstruction precludes a stent placement, then PCN is a safe alternative. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382022000600903 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382022000600903 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/s1677-5538.ibju.2022.0225 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Urologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Urologia |
dc.source.none.fl_str_mv |
International braz j urol v.48 n.6 2022 reponame:International Braz J Urol (Online) instname:Sociedade Brasileira de Urologia (SBU) instacron:SBU |
instname_str |
Sociedade Brasileira de Urologia (SBU) |
instacron_str |
SBU |
institution |
SBU |
reponame_str |
International Braz J Urol (Online) |
collection |
International Braz J Urol (Online) |
repository.name.fl_str_mv |
International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU) |
repository.mail.fl_str_mv |
||brazjurol@brazjurol.com.br |
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1750318078384668672 |