ObjectiveTo evaluate the safety, efficacy, tolerability, and cost‐effectiveness of bedside or office‐based ureteric stent insertion.MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta‐Analyses‐Protocols (PRISMA‐P) and A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 guidelines, we searched PubMed/the Medical Literature Analysis and Retrieval System Online (MEDLINE), the Excerpta Medica dataBASE (EMBASE), Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), and Dimensions for English‐language studies from 1978 to April 2023. Inclusion criteria focused on primary ureteric stent placements outside of the operating theatre (OT).ResultsA total of 15 studies involving 2072 stents were included. Success rates for correctly positioned stents in bedside or office‐based insertions ranged from 60% to 95.8%, with most studies reporting ≥80% success rates. Common failure reasons included impacted stones and difficulty identifying the ureteric orifice. Pain and tolerability were assessed using various methods, with validated tools indicating moderate pain levels, but most patients would undergo the procedure again under local anaesthesia. Complication rates were generally low, with minor complications such as haematuria or postoperative fever being the most common. Procedural costs were significantly lower in non‐OT settings, with estimates indicating savings of up to four‐fold.ConclusionBedside or office‐based ureteric stent insertion is a viable alternative to OT procedures, offering high success rates, manageable pain levels, low complication rates, and substantial cost savings. This approach is particularly advantageous in settings with limited OT access, highlighting its potential for broader adoption in urological practice. Future research should focus on standardising pain assessment methods and randomised studies.

中文翻译：

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手术室外输尿管支架置入术：挑战与机遇


目的评价床旁或诊室输尿管支架置入术的安全性、有效性、耐受性和成本效益。方法遵循系统评价和荟萃分析方案的首选报告项目 （PRISMA-P） 和评估系统评价的测量工具 （AMSTAR） 2 指南，我们检索了 PubMed/在线医学文献分析和检索系统 （MEDLINE）、Excerpta Medica 数据库 （EMBASE）、Google Scholar、Cochrane 对照试验中心注册库 （CENTRAL） 和 1978 年至 2023 年 4 月的英语语言研究维度。纳入标准侧重于手术室 （OT） 外的初次输尿管支架置入。结果共纳入 15 项研究，涉及 2072 个支架。在床旁或诊室放置中正确定位支架的成功率从 60% 到 95.8% 不等，大多数研究报告的成功率为 ≥80%。常见的失败原因包括结石嵌塞和难以识别输尿管口。使用各种方法评估疼痛和耐受性，经过验证的工具表明中度疼痛程度，但大多数患者会在局部麻醉下再次接受手术。并发症发生率普遍较低，最常见的是血尿或术后发热等轻微并发症。在非 OT 环境中，手术成本显著降低，估计显示节省高达 4 倍。结论床旁或诊室输尿管支架置入术是 OT 手术的可行替代方案，成功率高、疼痛程度可控、并发症发生率低，可节省大量成本。这种方法在 OT 可及性有限的情况下特别有利，突出了它在泌尿外科实践中更广泛采用的潜力。 未来的研究应侧重于标准化疼痛评估方法和随机研究。