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Hemostatic agents used for nephrostomy tract closure after tubeless PCNL: a systematic review and meta-analysis

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Abstract

To evaluate the role of hemostatic agents used for nephrostomy tract closure after tubeless percutaneous nephrolithotomy (PCNL). A systematic review of Pubmed, Embase and Cochrane was performed. All studies that compared hemostatic agents with common methods (silk stitch or pressure dressing) were included. The analyzed outcomes were hospital stay, operative time, blood loss, transfusion rate, fever rate, and complication rate. A total of eight articles including six RCTs met our criteria. Hemostatic agents showed short hospital stay (MD −4.54, 95 % CI −6.78 to −2.36, p < 0.0001). There was no difference between hemostatic agents and common methods on operative time (MD 2.00, 95 % CI −17.32 to 21.33, p = 0.84), blood loss (MD −0.19, 95 % CI −0.41 to 0.03, p = 0.08), transfusion rate (OR 1.42, 95 % CI 0.34–5.96, p = 0.63), fever rate (OR 1.02, 95 % CI 0.33–3.12, p = 0.97) and complication rate (OR 1.02, 95 % CI 0.33–3.12, p = 0.97). Eight studies including six RCTs showed that use of hemostatic agents was safe. Hemostatic agents showed short hospital stay. There were no difference between hemostatic agents and common methods on blood loss, transfusion rate, fever rate, and complication rate.

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Abbreviations

PCNL:

Percutaneous nephrolithotomy

RCT:

Randomized controlled trial

CCS:

Case–control studies

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Urology, Xiangya Hospital, Central South University, Changsha, 410000, Hunan, China

    Cui Yu, Zhou Xu, Wang Long, Liu Longfei, Zeng Feng, Qi Lin, Zu Xiongbing & Chen Hequn

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  1. Cui Yu
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  2. Zhou Xu
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  3. Wang Long
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  4. Liu Longfei
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  5. Zeng Feng
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  6. Qi Lin
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  7. Zu Xiongbing
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  8. Chen Hequn
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Corresponding author

Correspondence to Chen Hequn.

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C. Yu and Z. Xu, as first co-author, contributed equally to this work.

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Yu, C., Xu, Z., Long, W. et al. Hemostatic agents used for nephrostomy tract closure after tubeless PCNL: a systematic review and meta-analysis. Urolithiasis 42, 445–453 (2014). https://doi.org/10.1007/s00240-014-0687-7

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  • DOI: https://doi.org/10.1007/s00240-014-0687-7

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