Comparison Between Extracorporeal Shock Wave Lithotripsy and Ureteroscopic Lithotripsy for Treating Large Proximal Ureteral Stones: A Meta-analysis - 28/03/15
Abstract |
Objective |
To compare extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic lithotripsy (URSL) in terms of efficacy, complications, and overall efficiency in the management of proximal ureteral calculi. ESWL and URSL are the 2 most common modalities for treating ureteral stones. Previous studies and meta-analyses suggest that for stones <10 mm, ESWL is safer and of comparable efficacy compared with URSL. However, the choice between one modality over the other for the treatment of stones >10 mm is not as clear.
Methods |
The literature was reviewed in the databases, and resulting reports were screened for relevance. This process yielded 10 articles, which were analyzed in terms of the initial stone-free rate (primary outcome measure) compared between the 2 treatment modalities. Pretreatment rate, operation time, auxiliary procedure rate, and complication rate constituted secondary measures in the analysis.
Results |
A statistically higher initial stone-free rate was demonstrated for URSL compared with ESWL (odds ratio [OR] = 0.349; 95% confidence interval [CI] = 0.183-0.666; P = .001). ESWL showed a statistically higher retreatment rate compared with URSL (OR = 7.192; 95% CI = 4.934-10.482; P <.001). The 2 treatment modalities did not show statistically significant differences in mean operating time (OR = 10.35; 95% CI = −0.29 to 20.99; P = .056), auxiliary procedure rate (OR = 1.043; 95% CI = 0.415-2.616; P = .929), or in the complication rate (OR = 0.78; 95% CI = 0.304-1.984; P = .598).
Conclusion |
For treating large (>10 mm) proximate ureteral stones, URSL tends to be more effective than ESWL, yet without adding significant risk.
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Xin Cui and Fan Ji contributed equally to this work. |
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Financial Disclosure: The authors declare that they have no relevant financial interests. |
Vol 85 - N° 4
P. 748-756 - avril 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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