Day care surgery versus inpatient percutaneous nephrolithotomy: A systematic review and meta-analysis. (September 2020)

• Record Type: Journal Article
• Authors: Gao, Meng; Zeng, Feng; Zhu, Zewu; Zeng, Huimin; Chen, Zhiyong; Li, Yang; Yang, Zhongqing; Cui, Yu; He, Cheng; Chen, Jinbo; Chen, Hequn
• Is Part Of: International journal of surgery. Volume 81(2020)
• Page Start: 132
• Page End: 139
• Publication Date: 2020-09
• Subjects: Percutaneous nephrolithotomy -- Day surgery -- Safety -- Kidney calculi; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2020.07.056
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Purpose: Day care percutaneous nephrolithotomy is being performed rapidly. This meta-analysis aimed to assess the safety and efficacy of PCNL as a day care surgical procedure compared to conventional inpatient PCNL. Methods: Randomized controlled trials and clinical controlled trials involving day care percutaneous nephrolithotomy were included by searching PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL) and EMBASE up to Jan 2020. We completed a meta-analysis to assess the two surgical procedures. Results: Four retrospective case-controlled trials, one prospective cohort study and one randomized controlled trial were included in the meta-analysis. The meta-analysis revealed that there was no significant difference between the day care PCNL and inpatient PCNL groups in the stone-free rate (OR = 1.49; 95% CI, 0.83 to 2.67; P = 0.18). The mean overall complication rates were 13.6% and 24.4% in the day care and inpatient PCNL groups, respectively (OR = 0.47; 95% CI, 0.30 to 0.72; P < 0.001). The two groups had similar readmission rates (OR = 1.73, 95% CI, 0.67 to 4.50, P = 0.26). In addition, day care PCNL was associated with a shorter operative time (WMD = −11.89 min; 95% CI, −20.37 to −3.42; P = 0.006) and shorter hospital stay (WMD = −61.01 h; 95% CI, −107.54 to −12.48; P = 0.01). Conclusions: Our meta-analysis demonstrated that PCNL can be performed safely and efficiently in selected patients as a day care surgical procedure. Highlights: Day care percutaneous nephrolithotomy (PCNL) is being increasingly performed. Our study is the first meta-analysis to assess safety and effectiveness of PCNL as day care surgery. Compared with inpatient PCNL, day care PCNL is safe and will not increase complications or hospital readmission rate.