Comparison of Vacuum Suction Sheath and Non-Vacuum Suction Sheath in Minimally Invasive Percutaneous Nephrolithotomy: A Meta-Analysis

Objective To evaluate the clinical efficacy of minimally invasive percutaneous nephrolithotomy (mPCNL) with vacuum suction sheath in the treatment of renal calculi. Methods: We collected relevant studies of vacuum suction sheath and non-vacuum sheath mPCNL from PubMed, Embase, and Cochrane databases for a meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Results: 7 studies were included (4 randomized controlled studies, 3 retrospective studies involving 1803 patients). The final meta-analysis results showed that the operative time (Standardised Mean Difference [SMD] = -0.84, 95% CI [-1.20; -0.48], P < 0.001), auxiliary procedures (Odds Ratio [OR] = 0.61, 95% CI [0.46; 0.81], P < 0.001) and complications in the vacuum suction sheath group were significantly lower than those in the non-vacuum sheath group. The immediate and final stone-free rates (OR = 1.69, 95% CI [1.30; 2.18], P < 0.001; OR = 1.44, 95% CI [0.98; 2.13], P = 0.039) were also significantly lower in the vacuum suction sheath group. Conclusion: This study indicates that the application of vacuum suction sheath in mPCNL can significantly shorten the operative time and patient hospitalization, reduce auxiliary procedures and complications (especially fever, urinary tract infection, and pain).