Ultrasound versus fluoroscopy-guided extracorporeal shockwave lithotripsy in renal calculi: a systematic review and meta-analysis

被引:2
作者
Ramadhan, Mohammed [1 ]
Braga, Arthur [2 ]
Alzaid, Mohammad [3 ]
Benzouak, Tarek [4 ]
Hamouche, Fadl [5 ,7 ]
Almarzouq, Ahmad [1 ,6 ]
机构
[1] Jaber Al Ahmad Hosp, Dept Surg, South Surra, Kuwait
[2] Bahiana Sch Med & Publ Hlth, Salvador, Ba, Brazil
[3] Univ Manchester, Sch Med Sci, Manchester, England
[4] McGill Univ, Fac Med, Montreal, PQ, Canada
[5] Univ Calgary, Dept Surg, Div Urol, Calgary, AB, Canada
[6] Sabah Al Ahmad Urol Ctr, Dept Surg, Shuwaikh Med Area, Kuwait, Kuwait
[7] Southern Alberta Inst Urol, Calgary, AB T2V 1P9, Canada
关键词
Shockwave lithotripsy; Ultrasound; Fluoroscopy; Kidney stones; Renal calculi;
D O I
10.1007/s00240-025-01696-2
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Extracorporeal shockwave lithotripsy (ESWL) is one of the first-line treatments in the management of renal stones and is usually performed using fluoroscopic (FS) guidance. Ultrasonography (US) is a potential alternative with minimal radiation exposure. The primary aim of this study was to compare the stone free rate (SFR) between US and FS guided ESWL. The secondary outcomes were overall complications, re-intervention rate, hematuria, UTI, pain occurrence and number of shocks required. A prospectively registered systematic review and meta-analysis (CRD42024511335) according to PRISMA guidelines, was conducted. MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, were searched up to February 15, 2024. Snowballing techniques and Google Scholar were used for external gray literature. Adult and pediatric subgroups were pooled and individually analyzed. Twelve studies were identified with 2673 patients. Ultrasonography yielded a significantly favorable SFR (OR 1.43;95%CI [1.06-1.94]; P = 0.02). This difference was found only in the adult subgroup. No differences were found between modalities, nor within any subgroup in terms of secondary outcomes. In this meta-analysis, US-ESWL demonstrated a higher SFR compared to standard FS-ESWL However, this finding was shown only in adult patients, and although there was no difference in pediatric patients, the minimized radiation exposure remains an attractive attribute in US-ESWL.These results should be interpreted cautiously, due to a limited number of RCTs and heterogeneity between studies. More research is needed especially in pediatric populations, to further elucidate the role of US in ESWL.
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页数:12
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