Effectiveness of Percutaneous Nephrolithotomy, Retrograde Intrarenal Surgery, and Extracorporeal Shock Wave Lithotripsy for Treatment of Renal Stones: A Systematic Review and Meta-Analysis
- Authors
- Kim, Chan Hee; Chung, Doo Yong; Rha, Koon Ho; Lee, Joo Yong; Lee, Seon Heui
- Issue Date
- Jan-2021
- Publisher
- MDPI
- Keywords
- Extracorporeal shock wave lithotripsy (SWL); Percutaneous nephrolithotomy (PCNL); Retrograde intrarenal surgery (RIRS); Urolithiasis
- Citation
- MEDICINA-LITHUANIA, v.57, no.1, pp.1 - 23
- Journal Title
- MEDICINA-LITHUANIA
- Volume
- 57
- Number
- 1
- Start Page
- 1
- End Page
- 23
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/79936
- DOI
- 10.3390/medicina57010026
- ISSN
- 1010-660X
- Abstract
- Background and objectives: To perform a updated systematic review and meta-analysis comparing effectiveness of percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), and extracorporeal shock wave lithotripsy (ESWL) for treatment of renal stones (RS). Materials and Methods: A total of 37 studies were included in this systematic review and meta-analysis about effectiveness to treat RS. Endpoints were stone-free rates (SFR), incidence of auxiliary procedure, retreatment, and complications. We also conducted a sub-analysis of ≥2 cm stones. Results: First, PCNL had the highest SFR than others regardless of stone sizes and RIRS showed a higher SFR than ESWL in <2 cm stones. Second, auxiliary procedures were higher in ESWL than others, and it did not differ between PCNL and RIRS. Finally, in <2 cm stones, the retreatment rate of ESWL was higher than others. RIRS required significantly more retreatment procedures than PCNL in ≥2 cm stones. Complication was higher in PCNL than others, but there was no statistically significant difference in complications between RIRS and PCNL in ≥2 cm stones. For ≥2 cm stones, PCNL had the highest SFR, and auxiliary procedures and retreatment rates were significantly lower than others. Conclusions: We suggest that PCNL is a safe and effective treatment, especially for large RS. © 2020 by the authors.
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