Mohammed Ramadhan, Arthur Braga, Mohammad Alzaid, Tarek Benzouak, Fadl Hamouche, Ahmad Almarzouq
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引用次数: 0
Abstract
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.
期刊介绍:
Official Journal of the International Urolithiasis Society
The journal aims to publish original articles in the fields of clinical and experimental investigation only within the sphere of urolithiasis and its related areas of research. The journal covers all aspects of urolithiasis research including the diagnosis, epidemiology, pathogenesis, genetics, clinical biochemistry, open and non-invasive surgical intervention, nephrological investigation, chemistry and prophylaxis of the disorder. The Editor welcomes contributions on topics of interest to urologists, nephrologists, radiologists, clinical biochemists, epidemiologists, nutritionists, basic scientists and nurses working in that field.
Contributions may be submitted as full-length articles or as rapid communications in the form of Letters to the Editor. Articles should be original and should contain important new findings from carefully conducted studies designed to produce statistically significant data. Please note that we no longer publish articles classified as Case Reports. Editorials and review articles may be published by invitation from the Editorial Board. All submissions are peer-reviewed. Through an electronic system for the submission and review of manuscripts, the Editor and Associate Editors aim to make publication accessible as quickly as possible to a large number of readers throughout the world.