Retrograde Intrarenal Surgery versus Percutaneous Nephrolithotomy in the Treatment of Solitary Kidney Calculi: a Meta-Analysis

Abstract Background: To assess the effectiveness and safety of retrograde intrarenal surgery(RIRS) and percutaneous nephrolithotomy(PCNL) as surgical management strategies for solitary kidney calculi. Methods: Our team searched the PubMed, Cochrane and Web of Science databases up to February 28, 2019, for relevant published studies. After data extraction and quality assessment, Review Manager 5.3.5.0 software was used to pool the data. Results: Four studies involving 314 patients were included in our meta-analysis. The pooled data showed that the stone-free rate(SFR) was higher in the PCNL group than in the RIRS group, and the difference was significant(OR:0.36, 95% CI: 0.20 to 0.67, P =0.001). No significant differences were found in minor complications or major complications between the RIRS and PCNL groups(P > 0.05, OR:0.79, 95% CI: 0.46 to 1.35;p > 0.05, OR:2.96, 95% CI: 0.67 to 12.96, respectively). Conclusions: Neither the minor nor the major complications of RIRS and PCNL showed any statistical differences. Additionally, PCNL provided a higher SFR than RIRS. There exists enormous heterogeneity in mean operation time. Overall, this meta-analysis may help urologists make decisions regarding interventions for solitary kidney calculi management. Keywords: Solitary kidney, Calculi, Retrograde Intrarenal surgery, Percutaneous Nephrolithotomy, Meta-analysis