A meta-analysis of the efficacy of ureteroscopic lithotripsy and extracorporeal shock wave lithotripsy on ureteral calculi

Ye, Xu; Lü, Yi; Li, Jian; Luo, Shunwen; Liu, Yang; Jia, Zhigang; Chen, Ping; Guo, Yu; Q, Zhao; Ma, Xiaoping; Jia, Shaofeng

doi:10.1590/s0102-86502014000500010

Cited by 10 publications

(5 citation statements)

References 26 publications

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“…Patients in the ESWL group achieved a 92.70% overall SFR with a 44.88% retreatment rate and an 11.02% auxiliary procedure rate [8]. In this study, the 1-month SFR in the ESWL group and URS group was 75.9% and 88.2%, which was in line with the previous ndings [16]. The residual calculi would serve as the infection source, which led to recurrence of calculi [9].…”

Section: Discussionsupporting

confidence: 84%

Ureteroscopic lithotripsy combined with stent placement contributed to long-term auto-release of lithangiuria in upper urinary tract after ureterolithotripsy

Sun

Zhao

2020

Preprint

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Background To investigate the clinical efficiency of ureterectasis combined with stent placement in the long-term auto-release of lithangiuria in upper urinary tract after ureterolithotripsy. Methods In this retrospective analysis, we included the patients (male: 314; female: 49; age: 32–78 yrs; median age: 53 yrs) admitted to our hospital between January 2014 and January 2018 underwent ureterolithotripsy (URS group, n = 178) and extracorporeal shock wave lithotripsy (ESWL group, n = 212) for treating lithangiuria in upper urinary tract. All the patients were followed up for 24–59 months after treatment (median: 38 months). Uni-variate and multi-variate Logistic regression analysis was used to analyze the factors that could affect the long-term release of lithangiuria in upper urinary tract. Then we compared the short diameter of the ureter surpassing the stenosis of iliac vessels and the long-term auto-release of lithotripsy between the two groups. Results Logistic regression analysis indicated that the risk of auto-release of the stones in the upper urinary tract in the URS group was significantly higher than that of the ESWL group (OR = 3.357, 95% CI: 1.234–9.137). Stent placement was an independent risk factor for long-term auto-release of lithotripsy (P < 0.01). The short diameter of the ureter surpassing the stenosis of iliac vessels after URS was significantly longer than that of the baseline level (6.06 ± 1.26 mm vs. 3.63 ± 0.98 mm, t = 20.88, P < 0.01). The short diameter of the ureter surpassing the stenosis of iliac vessels after ESWL showed no statistical differences compared with that of the baseline level (3.67 ± 1.02 mm vs. 3.61 ± 0.94 mm, t=-0.798, P = 0.425). Sixteen cases (2.8%) in the URS group showed auto-release of stones during the follow-up, which was significantly higher than that in the ESWL group with 6 cases (13.5%) presented auto-release of stones (χ2 = 6.895, P = 0.09). Conclusions The combination of URS and stent replacement induced obvious ureterctasis, which may contribute to the auto-release of stones in the upper urinary tract in the long-term.

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Section: Discussionsupporting

confidence: 84%

Ureteroscopic lithotripsy combined with stent placement contributed to long-term auto-release of lithangiuria in upper urinary tract after ureterolithotripsy

Sun

Zhao

2020

Preprint

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“…They demonstrated that SWL showed a lower SFR (p < 0.001, RR 0.82, 95% CI 0.74-0.90), a higher repeat treatment rate (p = 0.004, RR 3.46, 95% CI 1.50 to 7.97), lower patient satisfaction (p = 0.02, RR 0.87, 95% CI 0.78-0.98), lower postoperative complications (p = 0.40, RR 0.63, 95% CI 0.48 to 0.83), and shorter operation times (p = 0.002, SMD −1.12, 95% CI −1.81-−0.43) and hospital stays (p = 0.004, SMD −1.71, 95% CI −2.88-−0.55) than URSL. However, the authors did not analyze by stone size [34].…”

Section: Discussionmentioning

confidence: 99%

“…Xu et al studied a meta-analysis of the efficacy of URSL and SWL on ureteral calculi. They enrolled 13 papers and reported a SFR, repeat treatment rate, patient satisfaction, postoperative complications, operation time, and hospital stays [34]. They demonstrated that SWL showed a lower SFR (p < 0.001, RR 0.82, 95% CI 0.74-0.90), a higher repeat treatment rate (p = 0.004, RR 3.46, 95% CI 1.50 to 7.97), lower patient satisfaction (p = 0.02, RR 0.87, 95% CI 0.78-0.98), lower postoperative complications (p = 0.40, RR 0.63, 95% CI 0.48 to 0.83), and shorter operation times (p = 0.002, SMD −1.12, 95% CI −1.81-−0.43) and hospital stays (p = 0.004, SMD −1.71, 95% CI −2.88-−0.55) than URSL.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review on Comparative Analyses between Ureteroscopic Lithotripsy and Shock-Wave Lithotripsy for Ureter Stone According to Stone Size

et al. 2021

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Background and Objectives: This systematic review and meta-analysis was conducted to analyze the treatment outcomes of shock wave lithotripsy (SWL) and ureteroscopic lithotripsy (URSL) according to the ureteral stone size. Materials and Methods: In this systematic review, relevant articles that compared SWL and URSL for treatment of ureteral stones were identified. Articles were selected from four English databases including Ovid-Medline, Ovid-EMBASE, the Cochrane Central Register of controlled Trials (Central), and Google Scholar. A quality assessment was carried out by our researchers independently using the Scottish Intercollegiate Guidelines Network (SIGN). A total of 1325 studies were identified, but after removing duplicates, there remained 733 studies. Of these studies, 439 were excluded, 294 were screened, and 18 met the study eligibility criteria. Results: In randomized control trial (RCT) studies, URSL showed significantly higher SFR than SWL (p < 0.01, OR= 0.40, 95% CI 0.30–0.55, I² = 29%). The same results were shown in sub-group analysis according to the size of the stone (<1 cm: p < 0.01, OR = 0.40, 95% CI 0.25–0.63; >1 cm: p < 0.01, OR = 0.38, 95% CI 0.19–0.74, I² = 55%; not specified: p < 0.01, OR = 0.43, 95% CI 0.25–0.72, I² = 70%). In the non-RCT studies, the effectiveness of the URSL was significantly superior to that of SWL (p < 0.01, OR = 0.33, 95% CI 0.21–0.52, I² = 83%). Retreatment rate was significantly lower in URSL than in SWL regardless of stone size (p < 0.01, OR = 10.22, 95% CI 6.76–15.43, I² = 54%). Conclusions: Meta-analysis results show that SFR was higher than SWL in URSL and that URSL was superior to SWL in retreatment rate. However, more randomized trials are required to identify definitive conclusions.

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“…En la búsqueda sistemática se encontró dos revisiones sistemáticas, de las cuales se seleccionó la RS de Xu (43) para los desenlaces de tasa libre cálculo, tasa de complicaciones y retratamiento.…”

Section: Pregunta 5: En Pacientes Con Litiasis Ureteral No Proximal unclassified

Guía de práctica clínica para el tratamiento quirúrgico de pacientes con urolitiasis en el Seguro Social del Perú (EsSalud)

et al. 2019

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Introducción. El presente artículo resume la guía de práctica clínica (GPC) para el tratamiento quirúrgico de pacientes con urolitiasis en el Seguro Social del Perú (EsSalud). Objetivo. Proveer recomendaciones clínicas basadas en evidencias para la para el tratamiento quirúrgico de los pacientes con urolitiasis en EsSalud. Método. Se conformó un grupo elaborador de la guía (GEG) constituido por médicos urólogos y metodólogos, los cuales formularon las preguntas clínicas que fueron respondidas dentro de la presente GPC. Para cada una de estas preguntas se realizó búsquedas de revisiones sistemáticas y de estudios primarios (cuando se consideró pertinente) en PubMed durante el 2018. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas, posteriormente se evaluó la certeza de la evidencia usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Se programaron reuniones de trabajo periódicas en las cuales el GEG revisó la evidencia y formuló recomendaciones, puntos de buenas prácticas clínicas y flujogramas usando la metodología GRADE. La GPC fue aprobada con Resolución N° 66–IETSI-ESSALUD-2018. Resultados. Se abordó 6 preguntas clínicas sobre el tema de tratamiento quirúrgico en urolitiasis. En base a dichas preguntas se formularon 5 recomendaciones (2 recomendaciones fuertes y 3 recomendaciones condicionales), 21 puntos de buena práctica clínica, y 3 flujogramas de manejo. Conclusión. El presente artículo resume la metodología y las conclusiones basadas en evidencias de la GPC para el tratamiento quirúrgico de pacientes con urolitiasis en EsSalud.

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A meta-analysis of the efficacy of ureteroscopic lithotripsy and extracorporeal shock wave lithotripsy on ureteral calculi

Abstract: Compared to the ureteroscopic lithotripsy treatment, extracorporeal shock wave lithotripsy treatment provided a significantly lower post-treatment stone free rate, but it also obviously brought out less postoperative complications, shorter operation time and hospital stays.

Cited by 10 publications

References 26 publications

Ureteroscopic lithotripsy combined with stent placement contributed to long-term auto-release of lithangiuria in upper urinary tract after ureterolithotripsy

Ureteroscopic lithotripsy combined with stent placement contributed to long-term auto-release of lithangiuria in upper urinary tract after ureterolithotripsy

A Systematic Review on Comparative Analyses between Ureteroscopic Lithotripsy and Shock-Wave Lithotripsy for Ureter Stone According to Stone Size

Guía de práctica clínica para el tratamiento quirúrgico de pacientes con urolitiasis en el Seguro Social del Perú (EsSalud)

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