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Safety and efficacy of extracorporeal shock wave lithotripsy vs. flexible ureteroscopy in the treatment of urinary calculi: A systematic review and meta-analysis
OBJECTIVE: This study aims to compare the safety and efficacy of extracorporeal shock wave lithotripsy (SWL) and flexible ureteroscopy lithotripsy (f-URS) in treating urinary tract stones. METHODS: We systematically searched PubMed, Embase, and Cochrane for literature comparing SWL with f-URS. The p...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9676362/ https://www.ncbi.nlm.nih.gov/pubmed/36420414 http://dx.doi.org/10.3389/fsurg.2022.925481 |
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author | Lv, Guangda Qi, Wenqiang Gao, Han Zhou, Yongheng Zhong, Minglei Wang, Kai Liu, Yunxing Zhang, Qiang Zhou, Changkuo Li, Yan Zhang, Lingling Zhang, Dongqing |
author_facet | Lv, Guangda Qi, Wenqiang Gao, Han Zhou, Yongheng Zhong, Minglei Wang, Kai Liu, Yunxing Zhang, Qiang Zhou, Changkuo Li, Yan Zhang, Lingling Zhang, Dongqing |
author_sort | Lv, Guangda |
collection | PubMed |
description | OBJECTIVE: This study aims to compare the safety and efficacy of extracorporeal shock wave lithotripsy (SWL) and flexible ureteroscopy lithotripsy (f-URS) in treating urinary tract stones. METHODS: We systematically searched PubMed, Embase, and Cochrane for literature comparing SWL with f-URS. The primary outcomes we focused on were stone-free rate (SFR) and complications; the secondary outcomes were operation time, hospital stay, retreatment rate, number of sessions, and auxiliary procedures rate. We used ReviewManager version 5.4.1 and STATA version 14.2 for meta-analysis. RESULTS: Seventeen studies with a total of 2,265 patients were included in the meta-analysis, including 1,038 patients in the SWL group and 1,227 patients in the f-URS group. The meta-analysis indicated that patients in the f-URS group had higher SFR than those in the SWL group [odds ratio (OR): 2.00, 95% confidence interval (CI): 1.29–3.12, p = 0.002]. In addition, we found no significant difference in complications (OR: 1.08, 95% CI: 0.85–1.37) between the two treatments. Also, we found that the retreatment rate and the auxiliary procedure rate in the f-URS group were significantly lower than those in the SWL group (OR: 0.08, 95% CI: 0.02–0.24, p < 0.00001; OR: 0.30, 95% CI: 0.11–0.83, p = 0.02). Moreover, the number of sessions in the f-URS group was significantly lower than that in the SWL group [mean difference (MD): −1.96, 95% CI: −1.55 to −0.33, p = 0.003]. However, the operation time and hospital stay in the f-URS group were significantly longer than those in the SWL group (MD: 11.24, 95% CI: 3.51–18.56, p = 0.004; MD: 1.14, 95% CI: 0.85–1.42, p < 0.00001). CONCLUSION: For 1–2-cm urinary stones, f-URS can achieve a higher SFR than SWL while having a lower retreatment rate, number of sessions, and auxiliary procedure rate. For urinary stones <1 cm, there was no significant difference in SFR between SWL and f-URS groups. The SWL group has a shorter operative time and hospital stay than the f-URS group. |
format | Online Article Text |
id | pubmed-9676362 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-96763622022-11-22 Safety and efficacy of extracorporeal shock wave lithotripsy vs. flexible ureteroscopy in the treatment of urinary calculi: A systematic review and meta-analysis Lv, Guangda Qi, Wenqiang Gao, Han Zhou, Yongheng Zhong, Minglei Wang, Kai Liu, Yunxing Zhang, Qiang Zhou, Changkuo Li, Yan Zhang, Lingling Zhang, Dongqing Front Surg Surgery OBJECTIVE: This study aims to compare the safety and efficacy of extracorporeal shock wave lithotripsy (SWL) and flexible ureteroscopy lithotripsy (f-URS) in treating urinary tract stones. METHODS: We systematically searched PubMed, Embase, and Cochrane for literature comparing SWL with f-URS. The primary outcomes we focused on were stone-free rate (SFR) and complications; the secondary outcomes were operation time, hospital stay, retreatment rate, number of sessions, and auxiliary procedures rate. We used ReviewManager version 5.4.1 and STATA version 14.2 for meta-analysis. RESULTS: Seventeen studies with a total of 2,265 patients were included in the meta-analysis, including 1,038 patients in the SWL group and 1,227 patients in the f-URS group. The meta-analysis indicated that patients in the f-URS group had higher SFR than those in the SWL group [odds ratio (OR): 2.00, 95% confidence interval (CI): 1.29–3.12, p = 0.002]. In addition, we found no significant difference in complications (OR: 1.08, 95% CI: 0.85–1.37) between the two treatments. Also, we found that the retreatment rate and the auxiliary procedure rate in the f-URS group were significantly lower than those in the SWL group (OR: 0.08, 95% CI: 0.02–0.24, p < 0.00001; OR: 0.30, 95% CI: 0.11–0.83, p = 0.02). Moreover, the number of sessions in the f-URS group was significantly lower than that in the SWL group [mean difference (MD): −1.96, 95% CI: −1.55 to −0.33, p = 0.003]. However, the operation time and hospital stay in the f-URS group were significantly longer than those in the SWL group (MD: 11.24, 95% CI: 3.51–18.56, p = 0.004; MD: 1.14, 95% CI: 0.85–1.42, p < 0.00001). CONCLUSION: For 1–2-cm urinary stones, f-URS can achieve a higher SFR than SWL while having a lower retreatment rate, number of sessions, and auxiliary procedure rate. For urinary stones <1 cm, there was no significant difference in SFR between SWL and f-URS groups. The SWL group has a shorter operative time and hospital stay than the f-URS group. Frontiers Media S.A. 2022-11-07 /pmc/articles/PMC9676362/ /pubmed/36420414 http://dx.doi.org/10.3389/fsurg.2022.925481 Text en © 2022 Lv, Qi, Gao, Zhou, Zhong, Wang, Liu, Zhang, Zhou, Li, Zhang and Zhang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Lv, Guangda Qi, Wenqiang Gao, Han Zhou, Yongheng Zhong, Minglei Wang, Kai Liu, Yunxing Zhang, Qiang Zhou, Changkuo Li, Yan Zhang, Lingling Zhang, Dongqing Safety and efficacy of extracorporeal shock wave lithotripsy vs. flexible ureteroscopy in the treatment of urinary calculi: A systematic review and meta-analysis |
title | Safety and efficacy of extracorporeal shock wave lithotripsy vs. flexible ureteroscopy in the treatment of urinary calculi: A systematic review and meta-analysis |
title_full | Safety and efficacy of extracorporeal shock wave lithotripsy vs. flexible ureteroscopy in the treatment of urinary calculi: A systematic review and meta-analysis |
title_fullStr | Safety and efficacy of extracorporeal shock wave lithotripsy vs. flexible ureteroscopy in the treatment of urinary calculi: A systematic review and meta-analysis |
title_full_unstemmed | Safety and efficacy of extracorporeal shock wave lithotripsy vs. flexible ureteroscopy in the treatment of urinary calculi: A systematic review and meta-analysis |
title_short | Safety and efficacy of extracorporeal shock wave lithotripsy vs. flexible ureteroscopy in the treatment of urinary calculi: A systematic review and meta-analysis |
title_sort | safety and efficacy of extracorporeal shock wave lithotripsy vs. flexible ureteroscopy in the treatment of urinary calculi: a systematic review and meta-analysis |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9676362/ https://www.ncbi.nlm.nih.gov/pubmed/36420414 http://dx.doi.org/10.3389/fsurg.2022.925481 |
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