The necessity of nephrostomy tube after percutaneous nephrolithotripsy: a meta-analysis and the trial sequential analysis

Objective The evaluate whether the placement of the tube should be advised after the percutaneous nephrolithotripsy by Meta-analysis and trial sequential analysis (TSA). Methods Computer retrieval of PubMed, Embase, Cochrane, CNKI and Wanfang, according to the inclusion and exclusion criteria were collected and screened out a randomized controlled studies on whether nephrostomy tube placement after the percutaneous nephrolithotripsy, published from inception to July 2016. Results Ten studies met the inclusion criteria with a total of 559 patients, including 288 cases of nephrostomy tube placement group and 271 cases of the tubeless group. The operation time (MD: 4.46; 95% CI: 0.65, 8.27; P=0.02), hospital stays (MD: 1.15; 95%CI: 0.93, 1.36 P<0.01), pain accessment (MD: 1.65; 95%CI: 0.59, 2.70; P=0.002), time to returning to work (MD: 1.34; 95% CI: 0.02, 2.67; P=0.045) of tubeless group were significantly lower than the tube group. Conclusions The tubeless group will not increase the incidence of fever and bleeding for the patient with out complex percutaneous nephrolithotripsy. But the trial sequential analysis does not allow us to draw the solid conclusion in operation time, fever and hemoglobin drop. Key words: Kidney stone; Percutaneous nephrolithotripsy (PCNL); Tube; Meta