Is extracorporeal shock wave lithotripsy a current treatment for urolithiasis? A systematic review

被引:15
作者
Bahilo Mateu, P. [1 ]
Budia Alba, A. [1 ]
Liatsikos, E. [2 ]
Trassierra Villa, M. [1 ]
Lopez-Acon, J. D. [1 ]
de Guzman Ordaz, D. [1 ]
Boronat Tormo, F. [1 ]
机构
[1] Hosp Univ & Politecn Le Fe, Serv Urol, Valencia, Spain
[2] Univ Patras, Patras, Greece
来源
ACTAS UROLOGICAS ESPANOLAS | 2017年 / 41卷 / 07期
关键词
Lithiasis; Extracorporeal lithotripsy; Endourology; Treatment; RETROGRADE INTRARENAL SURGERY; PROXIMAL URETERAL STONES; PROSPECTIVE RANDOMIZED-TRIAL; POLE RENAL STONES; PERCUTANEOUS NEPHROLITHOTOMY; FLEXIBLE URETERORENOSCOPY; URETEROSCOPIC LITHOTRIPSY; CALCULI; METAANALYSIS; LAPAROSCOPY;
D O I
10.1016/j.acuro.2017.01.011
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
Introduction: Technological advances have prompted a change in the management of urolithiasis. Endourological techniques are gaining importance because they are highly effective treatments. The aim of this study was to answer the question of whether extracorporeal shock wave lithotripsy (ESWL) is still a competitive alternative compared with other therapeutic modalities. Acquisition of evidence: We conducted a literature search of articles published in the past 5 years. We identified 12 randomized and comparative studies and assessed the methodology and results of the study variables. We performed a narrative synthesis of the included studies. To summarise the variables, we used the mean and standard deviation for continuous variables and absolute numbers and percentages for the qualitative variables. Analysis of the evidence: Of the studies reviewed, 7 evaluated the various treatments for nephrolithiasis and 5 evaluated the treatments for ureteral lithiasis. At the renal level, a stone-free rate of 33.33-91.5% at 3 months was reached with ESWL, while a rate of 90.4-100% was achieved with the other endourological techniques, without finding statistically significant differences in the studies. At the ureteral level, a stone-free rate of 73.5-82.2% at 3 months was reached with ESWL, while a rate of 79-94.1% was achieved with the other endourological techniques, without finding statistically significant differences in the studies. Conclusion: There is a lack of homogeneity among the published studies. ESWL is a minimally invasive treatment that with an appropriate technique and patient selection achieves high effectiveness, thus maintaining an important role at this time. (C) 2017 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.
引用
收藏
页码:426 / 434
页数:9
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