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Which is the best treatment of pediatric upper urinary tract stones among extracorporeal shockwave lithotripsy, percutaneous nephrolithotomy and retrograde intrarenal surgery: A systematic review

BMC Urology Nov 01, 2019

He Q, et al. - Researchers assessed extracorporeal shockwave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), and retrograde intrarenal surgery (RIRS) in terms of their efficacy and safety as treatment options for pediatric upper urinary tract stones. They analyzed data from 13 comparative studies that were identified from EMBASE, PubMed, and the Cochrane Library explored from their first available date to March 2018. Via meta-analysis of the stone free rate (SFR), complication rate, effectiveness quotient (EQ) and secondary outcome indicators, they evaluated the effectiveness and safety of the treatments. Shorter hospital stay and decreased operative time were offered by SWL as an outpatient procedure but the observed SFR with SWL was lower and the associated retreatment rate was higher when compared with the other two treatments. A higher SFR and EQ than SWL was provided by PCNL; nevertheless, longer operative time and fluoroscopy time than the other two procedures were noted with PCNL. A similar SFR as PCNL but a lower efficiency than PCNL was provided by RIRS.
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