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. 2021 Oct 25:8:726233.
doi: 10.3389/fsurg.2021.726233. eCollection 2021.

Comparison of the Efficacy and Safety of Extracorporeal Shock Wave Lithotripsy and Flexible Ureteroscopy for Treatment of Urolithiasis in Horseshoe Kidney Patients: A Systematic Review and Meta-Analysis

Xianyanling Yi  1 , Dehong Cao  1 , Pinghong You  2 , Xingyu Xiong  1 , Xiaonan Zheng  1 , Tao Jin  1 , Ge Peng  3 , Hang Xu  1 , Dazhou Liao  1 , Qiang Wei  1 , Hong Li  1 , Lu Yang  1 , Jianzhong Ai  1
Affiliations

Comparison of the Efficacy and Safety of Extracorporeal Shock Wave Lithotripsy and Flexible Ureteroscopy for Treatment of Urolithiasis in Horseshoe Kidney Patients: A Systematic Review and Meta-Analysis

Xianyanling Yi et al. Front Surg. .

Abstract

Background: Urolithiasis is the most common complication of horseshoe kidney (HK), which can be treated by extracorporeal shock wave lithotripsy (ESWL), flexible ureteroscopy (FURS), and percutaneous nephrolithotomy (PCNL). When comparing treatments of ESWL and FURS, it is unclear which is more efficient and safe. The objective of this study was to compare the efficacy and safety of FURS and SWL for the treatment of urolithiasis in HK patients. Methods: A systematic search of the Web of Science, PubMed, and EMBASE was performed in February 2021. Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias in each study. Results: Five studies published between 2008 and 2018 were synthesized in the present meta-analysis. The study revealed that FURS compared with SWL had greater initial and overall stone-free rates (SFRs). Risk ratios (RRs) were 2.46 (P < 0.00001) in initial SFRs, 1.36 (P = 0.02) in overall SFRs. No differences were found in the retreatment ratio, RRs were 0.49 (P = 0.43). In addition, no major complications were encountered, and all the complications were mild to moderate. Conclusion: The study demonstrated that FURS and SWL are effective and safe treatments for patients with HK with stones (<20 mm). Moreover, FURS has greater clearance rates and lower complication rates than SWL.

Keywords: efficacy; extracorporeal shock wave lithotripsy; flexible ureteroscopy; horseshoe kidney; urolithiasis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Preferred reporting items for systematic reviews and meta-analysis flowchart.
Figure 2
Figure 2
(A) Forest plot of initial stone-free rates for SWL vs. FURS. (B) Forest plot of overall stone-free rates for SWL vs. FURS. (C) Forest plot of retreatment ratios for SWL vs. FURS. SWL, extracorporeal shock wave lithotripsy; FURS, flexible ureteroscopy; CI, confidence interval; M–H, Mantel-Haenszel.
See this image and copyright information in PMC

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