1. Systematic review on active treatment for urinary fistula after partial nephrectomy.
- Author
-
Massouh Skorin R, Mahfouz A, and Escovar la Riva P
- Subjects
- Humans, Kidney, Nephrectomy adverse effects, Nephrectomy methods, Kidney Neoplasms surgery, Urinary Fistula etiology, Urinary Fistula surgery
- Abstract
Introduction: Urinary fistula is expected to become more frequent in urological practice as a result of expanding indication of partial nephrectomy given it's oncological results equivalent to those of radical nephrectomy but at a lower risk of progression to chronic kidney disease, lower cardiovascular morbidity, and overall mortality., Objectives: Review and compare different techniques of contemporary active management for urinary fistula after partial nephrectomy., Methods: A systematic literature search on the MEDLINE database was conducted in March 2020, combining the terms: "urine leak", "urine leakage", "urinary leak" and "urinary fistula", with: "partial nephrectomy", "nephron sparing surgery" and "renal sparing surgery". This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Only articles related to active treatment were eligible. Abstracts in English and Spanish from the last two decades were screened. No restriction based on study design nor the length of follow-up., Primary Outcomes: 1) Leak resolution rate 2) Time course of leak resolution and 3) Number of interventions needed for resolution., Results: Multiple studies were found. There were no randomized controlled trials. Urinary fistula can be solved in many ways with active treatment, with a high success rate (97.5%), an average of 1.4 intervention-per-patients and a mean time for leak resolution of 11 days (median of 3 days)., Conclusion: There is a high risk of bias due to the study's methodology. There is a broad range of effective alternatives and various approaches to solve urinary fistula in an appropriate timing., (Copyright © 2022 AEU. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2022
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