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Systematic Review

Effectiveness of Percutaneous Nephrolithotomy, Retrograde Intrarenal Surgery, and Extracorporeal Shock Wave Lithotripsy for Treatment of Renal Stones: A Systematic Review and Meta-Analysis

by
Chan Hee Kim
1,†,
Doo Yong Chung
2,†,
Koon Ho Rha
3,
Joo Yong Lee
3,4,* and
Seon Heui Lee
1,*
1
Department of Nursing Science, College of Nursing, Gachon University, Incheon 22212, Korea
2
Department of Urology, Inha University School of Medicine, Incheon 22212, Korea
3
Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea
4
Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul 03722, Korea
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Medicina 2021, 57(1), 26; https://doi.org/10.3390/medicina57010026
Submission received: 18 November 2020 / Revised: 21 December 2020 / Accepted: 26 December 2020 / Published: 30 December 2020
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
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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.
Keywords: urolithiasis; percutaneous nephrolithotomy (PCNL); retrograde intrarenal surgery (RIRS); extracorporeal shock wave lithotripsy (SWL) urolithiasis; percutaneous nephrolithotomy (PCNL); retrograde intrarenal surgery (RIRS); extracorporeal shock wave lithotripsy (SWL)

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MDPI and ACS Style

Kim, C.H.; Chung, D.Y.; Rha, K.H.; Lee, J.Y.; Lee, S.H. Effectiveness of Percutaneous Nephrolithotomy, Retrograde Intrarenal Surgery, and Extracorporeal Shock Wave Lithotripsy for Treatment of Renal Stones: A Systematic Review and Meta-Analysis. Medicina 2021, 57, 26. https://doi.org/10.3390/medicina57010026

AMA Style

Kim CH, Chung DY, Rha KH, Lee JY, Lee SH. Effectiveness of Percutaneous Nephrolithotomy, Retrograde Intrarenal Surgery, and Extracorporeal Shock Wave Lithotripsy for Treatment of Renal Stones: A Systematic Review and Meta-Analysis. Medicina. 2021; 57(1):26. https://doi.org/10.3390/medicina57010026

Chicago/Turabian Style

Kim, Chan Hee, Doo Yong Chung, Koon Ho Rha, Joo Yong Lee, and Seon Heui Lee. 2021. "Effectiveness of Percutaneous Nephrolithotomy, Retrograde Intrarenal Surgery, and Extracorporeal Shock Wave Lithotripsy for Treatment of Renal Stones: A Systematic Review and Meta-Analysis" Medicina 57, no. 1: 26. https://doi.org/10.3390/medicina57010026

APA Style

Kim, C. H., Chung, D. Y., Rha, K. H., Lee, J. Y., & Lee, S. H. (2021). Effectiveness of Percutaneous Nephrolithotomy, Retrograde Intrarenal Surgery, and Extracorporeal Shock Wave Lithotripsy for Treatment of Renal Stones: A Systematic Review and Meta-Analysis. Medicina, 57(1), 26. https://doi.org/10.3390/medicina57010026

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