Ahmad, M U; Siddiqui, S; Ashraf, F A; Iqbal, R; Ehsanullah, Sam; AlFayadh, A; Mrs, Siddiqui; Khan, M S; Furrer, M A (2024). Retrograde Ureteral Stents versus Percutaneous Nephrostomy in the Management of Malignant Ureteral Obstruction: A Systematic Review and Meta-Analysis. (In Press). Urology Elsevier 10.1016/j.urology.2024.05.042
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OBJECTIVE
To evaluate outcomes in cancer patients with ureteral obstruction by comparison of retrograde stenting and percutaneous nephrostomy techniques.
METHODS
Systematic review of all studies up to October 2023. Studies were identified from all major databases including MEDLINE, Cochrane, and EMBASE. All comparative studies between retrograde stenting and percutaneous nephrostomy were searched; studies with paediatric populations were excluded. Primary outcomes were procedure and intervention failure rates; secondary outcomes were infection, blockage, displacement and unplanned exchange rates along with procedure time and length of stay.
RESULTS
Eighteen studies with 1228 patients contributed to the summative outcome. Percutaneous nephrostomy was statistically superior to retrograde stenting for procedure failure rate (p<0.00001) and intervention failure rate (p=0.0004). Retrograde stenting was statistically superior to percutaneous nephrostomy for displacement rates (p=0.003), procedure time (p<0.00001) and length of stay (p<0.00001). Retrograde stenting showed no difference to percutaneous nephrostomy for infection rates (p=0.94), blockage rates (p=0.93), unplanned exchange rates (p=0.48), CONCLUSION: There is no absolute superiority for retrograde stenting or percutaneous nephrostomy for malignant ureteral obstruction. Both techniques have their advantages and disadvantages, with some comparable outcomes; patients are key when selecting the best technique. Larger studies are required to assess the outcomes of both techniques.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology |
UniBE Contributor: |
Furrer, Marc |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0090-4295 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
04 Jun 2024 13:31 |
Last Modified: |
05 Jun 2024 04:29 |
Publisher DOI: |
10.1016/j.urology.2024.05.042 |
PubMed ID: |
38830555 |
BORIS DOI: |
10.48350/197532 |
URI: |
https://boris.unibe.ch/id/eprint/197532 |
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