Dataset Information

Antibiotic prophylaxis for percutaneous nephrolithotomy: An updated systematic review and meta-analysis.

ABSTRACT:

Introduction

A single dose of preventive antibiotics is known to be sufficient to reduce the rate of infection-related complications in percutaneous nephrolithotomy (PCNL). However, some studies reported that the extended dose showed lower complications for high-risk groups. Therefore, we performed a systematic review and meta-analysis comparing single- and extended-dose antibiotic prophylaxis for PCNL.

Materials and methods

Relevant studies that compared single- and extended-dose antibiotic prophylactic therapies were identified. Articles were selected from PubMed, EMBASE, KoreaMed, and Google Scholar up to September 2021. Fever and systemic inflammatory response syndrome (SIRS) were compared by meta-analysis. A subgroup analysis was performed according to the degree of risk to the patient.

Results

A total of 10 articles were included in this study. There were no significant differences between single dose and extended dose in the rate of fever [p = 0.93, OR = 0.96, 95% confidence interval (CI) 0.44-2.13, I2 = 64%]. Extended dose showed lower rate of SIRS compared to single dose (p = 0.0005, OR = 1.81, 95% CI 1.30-2.53, I2 = 53%); in the subgroup analysis, extended dose also showed lower rates of SIRS compared to single dose in high-risk patients (p <0.0001, OR = 3.53, 95% CI 1.91-6.54, I2 = 36%).

Conclusions

The results of our meta-analysis showed that single-dose antibiotic prophylaxis can be effective for PCNL, but extended-dose antibiotics can be required in high-risk patients to reduce post-PCNL infection-related complications.

SUBMITTER: Jung HD

PROVIDER: S-EPMC9012355 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Antibiotic prophylaxis for percutaneous nephrolithotomy: An updated systematic review and meta-analysis.

Jung Hae Do HD Cho Kang Su KS Moon Young Joon YJ Chung Doo Yong DY Kang Dong Hyuk DH Lee Joo Yong JY

PloS one 20220415 4

<h4>Introduction</h4>A single dose of preventive antibiotics is known to be sufficient to reduce the rate of infection-related complications in percutaneous nephrolithotomy (PCNL). However, some studies reported that the extended dose showed lower complications for high-risk groups. Therefore, we performed a systematic review and meta-analysis comparing single- and extended-dose antibiotic prophylaxis for PCNL.<h4>Materials and methods</h4>Relevant studies that compared single- and extended-dose ...[more]

PMID: 35427380

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Project description:Introduction To compare the efficacy and safety of percutaneous nephrolithotomy (PCNL) in the oblique supine position (OSP) and the prone position (PP). Aim To perform a systematic review and meta-analysis to evaluate the efficacy and safety of OSP versus PP for PCNL. Material and methods A systematic literature search of PubMed, Ovid, SCOPUS, and citation lists was conducted to identify eligible comparative studies up to November 2022. All studies comparing OSP versus PP for PCNL were included. Statistical analysis was performed with the Collaboration’s Review Manager (RevMan) 5.4 software. Results Overall, eight studies were included involving 1185 patients (OSP = 634; PP = 551). There were no statistically significant differences between OSP and PP in age (WMD = –0.95 years; 95% CI: –2.12 to 0.21; p = 0.83) or proportion of male patients (OR = 0.02; 95% CI: –0.03 to 0.08; p = 0.43). We found that OSP was performed more frequently for smaller stone size and patients with higher BMI (WMD = –0.1 cm, 95% CI: –0.18 to –0.02; p = 0.01) and patients with higher BMI (WMD = 0.66 kg/m2; 95% CI: 0.29 to 1.03; p = 0.0005). The operation time was shorter in OSP than PP (WMD = –14 min; 95% CI: –27.00 to –1.00; p = 0.03). The reduction of hemoglobin was lower in OSP than PP (WMD = –0.39 g/dl; 95% CI: –0.60 to –0.13; p = 0.03). There was no significant difference in stone-free rate and hospitalization between the two groups (OR = 1.32; 95% CI: 0.98 to 1.78; p = 0.07; WMD = –5.99 h; 95% CI: –17.15 to 5.16; p = 0.29). The overall complications were fewer in OSP than in PP (OR = 0.59; 95% CI: 0.43 to 0.81; p = 0.001), but no difference was observed between the positions with regard to the major complications (Clavien-Dindo score ≥ 3) (OR = 0.76; 95% CI: 0.43 to 1.34; p = 0.35). Conclusions OSP showed non-inferior stone-free rate, blood loss, and hospitalization compared with PP. OSP may be superior in terms of operative time and complications than PP.

Project description:ObjectiveThe current study aimed to assess the efficacy and safety of percutaneous nephrolithotomy (PCNL) in obese and overweight individuals based on body mass index (BMI).MethodsWe electronically explored the databases of PubMed, CENTRAL, ScienceDirect, Embase, and Google Scholar databases for all types of comparative studies investigating the role of BMI on PCNL outcomes. Only studies defining obesity as >30 kg/m2 were included. Efficacy outcomes were stone-free rates and operating time while safety outcomes were complications and length of hospital stay (LOS).ResultsEighteen studies with 101,363 patients were included. We noted no difference in the stone-free rates after PCNL for morbid obese vs normal BMI patients (OR: 0.78 95% CI, 0.57, 1.08 I2 = 7% p = 0.13), overweight vs normal (OR: 1.01 95% CI, 0.89, 1.15 I2 = 1% p = 0.83) and obese vs normal patients (OR: 1.00 95% CI, 0.87, 1.16 I2 = 0% p = 0.95). PCNL operative time was significantly increased in morbid obese (MD: 9.36 95% CI, 2.85, 15.88 I2 = 76% p = 0.005) and obese patients as compared with normal patients (MD: 2.15 95% CI, 1.20, 3.10 I2 = 0% p < 0.00001), but not for overweight patients. There was no difference in the odds of complications between morbid obese vs normal (OR: 1.26 95% CI, 0.93, 1.72 I2 = 0% p = 0.13), overweight vs normal (OR: 1.11 95% CI, 0.96, 1.28 I2 = 0% p = 0.15), and obese vs normal patients (OR: 1.07 95% CI, 0.91, 1.27 I2 = 0% p = 0.40). LOS was significantly reduced in obese patients (MD: -0.12 95% CI, -0.20, -0.04 I2 = 0% p = 0.004) as compared to normal patients, but not for morbid obese or overweight patients.ConclusionPCNL has similar efficacy and safety in morbidly obese, obese, and overweight patients as compared to normal BMI patients with no difference in the stone-free and complication rates. Evidence suggests that operating time is increased in morbidly obese and obese patients and the latter may have shorter LOS.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42022313599.

Dataset Information

Antibiotic prophylaxis for percutaneous nephrolithotomy: An updated systematic review and meta-analysis.

Introduction

Materials and methods

Results

Conclusions

Publications

Antibiotic prophylaxis for percutaneous nephrolithotomy: An updated systematic review and meta-analysis.

Similar Datasets

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