Comparison between cold knife and laser urethrotomy for urethral stricture: a systematic review and meta-analysis of comparative trials
Comparison between cold knife and laser urethrotomy for urethral stricture: a systematic review and meta-analysis of comparative trials
复制标题
冷刀与激光尿道切开术治疗尿道狭窄的比较：比较试验的系统评价和荟萃分析
DOI：
10.1007/s00345-019-02729-3
复制
发表时间：
2019-03
影响因子：
3.4
通讯作者：
Qiang Wei
中科院分区：
文献类型：
--
作者：
Xiaonan Zheng;Xin Han;Dehong Cao;Hang Xu;Lu Yang;Jianzhong Ai;Qiang Wei
背景先前的研究比较了冷刀和激光尿道切开术治疗尿道狭窄后的有限参数，关于这两种技术的优越性仍然存在争议。本研究旨在更新证据，提供更好的临床guidance.MethodWe系统地检索Pubmed，Embase，www.example.com，和科克伦图书馆中央对照试验注册的文章比较冷刀和激光尿道切开术尿道狭窄。采用RevMan 5.3软件对最大尿流率（Qmax）、复发率、再手术率、并发症、手术时间、疼痛视觉模拟评分（VAS）等指标进行比较。与激光组相比，冷刀组的6个月Qmax更好（MD-0.95，95% CI-1.49至-0.41），3个月和12个月Qmax相似。复发率的比较未观察到显著性。激光组出血风险较低（OR 0. 08，95% CI 0. 01 - 0. 43），再次手术率较低（OR 0. 39，95% CI 0. 19 - 0. 81），手术时间较长（MD 4. 09，95% CI 3. 35 - 4. 82）。其他并发症和VAS疼痛score.ConclusionCold刀和激光尿道切开术有类似的疗效，短期和长期复发率和Qmax，除了冷刀组有稍好的6个月Qmax。而激光组出血风险低，再次手术率低，但手术时间较长。
BackgroundPrevious study compared limited number of parameters post the treatment of cold knife and laser urethrotomy for urethral stricture and controversy about the superiority of those two techniques still remains. This study aims to update the evidence and provide better clinical guidance.MethodWe systematically searched Pubmed, Embase, ClinicalTrial.gov, and Cochrane Library Central Register of Controlled Trials for articles comparing cold knife and laser urethrotomy for urethral stricture. Parameters including maximum urinary flow (Qmax), recurrence, reoperation, complications, operation time, and Visual Analog Scale (VAS) pain score were compared using RevMan 5.3.ResultsSeven articles involving 453 patients were eventually included. The cold-knife group had better 6-monthQmax(MD – 0.95, 95% CI – 1.49 to – 0.41) and similar 3-month and 12-monthQmaxcompared with the laser group. No significance was observed regarding the comparison of recurrence rate. The laser group had lower risk of bleeding (OR 0.08, 95% CI 0.01–0.43), lower rate of reoperation (OR 0.39, 95% CI 0.19–0.81) and longer operation time (MD 4.09, 95% CI 3.35–4.82). There was no significant difference in terms of other complications and VAS pain score.ConclusionCold knife and laser urethrotomy had similar efficacy regarding short-term and long-term recurrence rate andQmax, except that the cold-knife group had slightly better 6-monthQmax. However, the laser group had less risk of bleeding and lower rate of reoperation but also longer operation time.
登录
查看更多内容
影响因子：
0.5
作者：
J. Moreno Sierra;S. P. Prieto Nogal;I. Galante Romo;L. Fernández Montarroso;J. C. López Corral;A. Silmi Moyano
通讯作者：
J. Moreno Sierra;S. P. Prieto Nogal;I. Galante Romo;L. Fernández Montarroso;J. C. López Corral;A. Silmi Moyano
影响因子：
--
作者：
Gallegos, Maxx A;Santucci, Richard A
通讯作者：
Santucci, Richard A
影响因子：
2
作者：
A. Shoukry;W. N. Abouela;M. ElSheemy;A. Shouman;Kareem Daw;Ahmed A. Hussein;H. Morsi;M. A. Mohsen;H. Badawy;M. Eissa
通讯作者：
A. Shoukry;W. N. Abouela;M. ElSheemy;A. Shouman;Kareem Daw;Ahmed A. Hussein;H. Morsi;M. A. Mohsen;H. Badawy;M. Eissa
影响因子：
2
作者：
Dutkiewicz, Slawomir A.;Wroblewski, Mariusz
通讯作者：
Wroblewski, Mariusz
影响因子：
6.6
作者：
Bullock, Travis L.;Brandes, Steven B.
通讯作者：
Brandes, Steven B.