A Meta-analysis of the effect of presetting D-J stent on ureteroscopic lithotripsy

Abstract:

Objective：To evaluate the safety and efficacy of preoperative D-J stent placement in ureteroscopic lithotripsy（URL） by Meta-analysis. Methods：PubMed，Embase，Cochrane Library，VIP，Wanfang and CNKI database were used to collect the randomized controlled trial（RCT） or controlled trials of the effect of preoperative placement and not placement of D-J stent. The data were up－dated to June 2017. Quality of the literature was evaluated. Meta-analysis was performed using Revman 5.2. Sensitivity analysis and publication bias test of inclusion literature were assessed by the Stata 12.0. Results：A total of 12 440 patients were enrolled in 14 clinical studies. Meta-analysis showed that the stone-free rate（SFR） was higher in the intentional preoperative D-J stent（IPS） group than in the not preoperative D-J stent（NPS） group（RR=1.08，95%CI=1.02 to 1.14，P=0.007）. SFR of the renal and proximal ureteral calculi was higher in the IPS group than in the NPS group（RR=1.46，95%CI=1.05 to 2.03，P=0.02），and there was no signifi－cant difference in SFR of distal ureteral calculi between IPS group and NPS group（RR=1.14，95%CI=0.92 to 1.42，P=0.24），and it was the same result in terms of operative time（SMD=-0.21，95%CI=-0.73 to 0.32，P=0.44） and complications（RR=0.78，95%CI=0.52 to 1.18，P=0.25）. Conclusion：Preoperative D-J stent for URL can increase SFR，especially for kidney and proximal ureteral stones patients.