Effectiveness and Safety of Ureteroscopy Surgery in Treatment of Upper Ureteral Calculi: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 LIHan ¹ ,  WANGKun-jie ² , HUXing-ping ¹

1. Department of Urology, Fifth Chengdu People's Hospital, Chengdu 611130, China;
2. Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

WANGKun-jie, Email: wzwzlwww@qq.com

Keywords：

Upper ureteral calculi; Transurethral ureteroscopy lithotripsy; Etroperitoneal laparoscopic ureterolithotomy; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20140182

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Objective To systematically review the effectiveness and safety of transurethral ureteroscopy lithotripsy in the treatment of upper ureteral calculi. Methods We electronically searched The Cochrane Library (Issue 3, 2013), PubMed (1966 to 2013.8), EMbase (1990 to 2013.8), CNKI (1949 to 2013.9), CBM (1978 to 2013.9), VIP (1989 to 2013.8) and WanFang Data (1990 to 2013.8) for the randomized controlled studies (RCTs) related to retroperitoneoscopy ureterolithotomy versus transurethral ureteroscopy lithotripsy for upper ureteral calculi. Two reviewers independently screened literature, extracted data, and evaluated methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. Results A total of 16 RCTs involving 1 410 patients (transurethral ureteroscopy lithotripsy:747 cases; etroperitoneal laparoscopic ureterolithotomy:663 cases) were included. The results of meta-analysis showed that, transurethral ureteroscopy lithotripsy was lower than retroperitoneoscopy ureterolithotomy in success rates of surgery (OR=0.26, 95%CI 0.14 to 0.51), 3-day stone clearance rates (OR=0.06, 95%CI 0.03 to 0.11), and 1-month stone clearance rates (OR=0.21, 95%CI 0.08 to 0.53), while it showed superiority in operation time (MD=-22.35, 95%CI-35.29 to-9.41) and postoperative hospital stay (MD=-1.84, 95%CI-3.44 to-0.24). Conclusion Current evidence shows that, in the treatment of upper ureteral calculi, transurethral ureteroscopy lithotripsy causes less operation time and postoperative hospital stay, but it had no advantage in success rates of surgery, 3-day stone clearance rates, and 1-month stone clearance rates.

Citation： LIHan, WANGKun-jie, HUXing-ping. Effectiveness and Safety of Ureteroscopy Surgery in Treatment of Upper Ureteral Calculi: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2014, 14(9): 1119-1125. doi: 10.7507/1672-2531.20140182 Copy

1.	那彦群, 主编.中国泌尿外科疾病诊断治疗指南. 2009版.北京:人民卫生出版社, 2009:166-199.
2.	Khaladkar S, Modi J, Bhansali M, et al. Which is the best option to treat large (>1.5 cm) midureteric calculi?. J Laparoendosc Adv Surg Tech A, 2009, 19(4):501-504.
3.	刘鸣, 主编.系统评价、META-分析设计与实验方法.第1版.北京:人民卫生出版社, 2011:98-117.
4.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available at:www.cochrane-handbook.org.
5.	张翼飞, 梁朝朝, 郝宗耀, 等.两种方法治疗输尿管上段结石的比较.安徽医学, 2013, 34(2):124-126.
6.	邓孙林, 王忠.三种微刨术式治疗嵌顿性输尿管上段结石的疗效比较.临床医学工程, 2014, 19(4):535-537.
7.	郭辉权, 刘冠.上段输尿管结石三种微创治疗方法的对比分析.当代医学, 2012, 18(12):65-66.
8.	杨东.后腹腔镜与输尿管镜治疗输尿管结石的临床对比分析.临床研究, 2012, 10(36):466-467.
9.	金江江, 翁责茗, 张建球.后腹腔镜输尿管切开取石术与经尿道输尿管镜碎石术治疗复杂性输尿管上段结石的疗效观察.中国基层医药, 2013, 20(15):2368-2370.
10.	李海平, 杨艳颖, 韩子华, 等.后腹腔镜输尿管切开取石术与经尿道输尿管镜碎石术治疗输尿管上段结石的疗效比较.中国基层医药, 2010, 17(13):1826-1827.
11.	汤庆峰, 王绍勇, 洪战锋.腹膜后腹腔镜与输尿管镜治疗输尿管上段嵌顿性结石的对比研究.腹腔镜外科杂志, 2010, 15(11):864-865.
12.	马大富.腹膜后腹腔镜和输尿管镜治疗上输尿管结石疗效对比.临床医学, 2012, 32(2):62-63.
13.	王昌兵, 梁朝朝, 顾恒, 等.输尿管上段复杂结石的3种微创治疗比较.安徽医科大学学报, 2011, 46(7):724-725.
14.	任知良, 张大萌, 鞠俊玉.输尿管镜下与腹腔镜下治疗输尿管结石比较.浙江临床医学, 2011, 2(13):154-155.
15.	刘晖.输尿管镜与后腹腔镜手术治疗输尿管上段结石疗效比较.白求恩军医学院学报, 2007, 5(4):217-218.
16.	方友强, 邱剑光, 吴杰英, 等.输尿管镜与后腹腔镜手术治疗输尿管上段结石的疗效比较.中华腔镜泌尿外科杂志(电子版), 2012, 6(2):24-27.
17.	敖劲松, 汪波, 邱承俊, 等.输尿管镜与后腹腔镜手术治疗输尿管上段结石的疗效比较.中华腔镜泌尿外科杂志(电子版), 2013, 7(4):289-291.
18.	Fang YQ, Qiu JG, Wang DJ, et al. Comparative study on ureteroscopic lithotripsy and laparoscopic ureterolithotomy for treatment of unilateral upper ureteral stones. Acta Cir Bras, 2012, 27(3):1678-1684.
19.	Abbas B, Nasser S, Amirmohsen Z, et al. Retrograde, Antegrade, and Laparoscopic Approaches for the Management of Large, Proximal Ureteral Stones:A Randomized Clinical Trial. J Endourology, 2008, 22(12):2677-2680.
20.	Wang YY, Hou JQ, Wen DG, et al. Comparative analysis of upper ureteral stones(>15 mm) treated with retroperitoneoscopic ureterolithotomy and ureteroscopic pneumatic lithotripsy. Int Urol Nephrol, 2010, 42(19):897-901.
21.	Leonardo C, Simone G, Rocco P, et al. Laparoscopic ureterolithotomy:minimally invasive second line treatment. Int Urol Nephrol, 2011, 43(3):651-654.
22.	Farooq SJ, Khan N, Khan M. Retroperitoneal laparoscopic ureterolithotomy-a single centre 10 year experience. Int J Surg, 2011, 9(2):160-164.
23.	Flasko T, Holman E, Kovacs G, et al. Laparoscopic ureterolithotomy:the method of choice in selected cases. J Laparoendosc Adv Surg Tech A, 2005, 15(2):149-152.

1. 那彦群, 主编.中国泌尿外科疾病诊断治疗指南. 2009版.北京:人民卫生出版社, 2009:166-199.
2. Khaladkar S, Modi J, Bhansali M, et al. Which is the best option to treat large (>1.5 cm) midureteric calculi?. J Laparoendosc Adv Surg Tech A, 2009, 19(4):501-504.
3. 刘鸣, 主编.系统评价、META-分析设计与实验方法.第1版.北京:人民卫生出版社, 2011:98-117.
4. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available at:www.cochrane-handbook.org.
5. 张翼飞, 梁朝朝, 郝宗耀, 等.两种方法治疗输尿管上段结石的比较.安徽医学, 2013, 34(2):124-126.
6. 邓孙林, 王忠.三种微刨术式治疗嵌顿性输尿管上段结石的疗效比较.临床医学工程, 2014, 19(4):535-537.
7. 郭辉权, 刘冠.上段输尿管结石三种微创治疗方法的对比分析.当代医学, 2012, 18(12):65-66.
8. 杨东.后腹腔镜与输尿管镜治疗输尿管结石的临床对比分析.临床研究, 2012, 10(36):466-467.
9. 金江江, 翁责茗, 张建球.后腹腔镜输尿管切开取石术与经尿道输尿管镜碎石术治疗复杂性输尿管上段结石的疗效观察.中国基层医药, 2013, 20(15):2368-2370.
10. 李海平, 杨艳颖, 韩子华, 等.后腹腔镜输尿管切开取石术与经尿道输尿管镜碎石术治疗输尿管上段结石的疗效比较.中国基层医药, 2010, 17(13):1826-1827.
11. 汤庆峰, 王绍勇, 洪战锋.腹膜后腹腔镜与输尿管镜治疗输尿管上段嵌顿性结石的对比研究.腹腔镜外科杂志, 2010, 15(11):864-865.
12. 马大富.腹膜后腹腔镜和输尿管镜治疗上输尿管结石疗效对比.临床医学, 2012, 32(2):62-63.
13. 王昌兵, 梁朝朝, 顾恒, 等.输尿管上段复杂结石的3种微创治疗比较.安徽医科大学学报, 2011, 46(7):724-725.
14. 任知良, 张大萌, 鞠俊玉.输尿管镜下与腹腔镜下治疗输尿管结石比较.浙江临床医学, 2011, 2(13):154-155.
15. 刘晖.输尿管镜与后腹腔镜手术治疗输尿管上段结石疗效比较.白求恩军医学院学报, 2007, 5(4):217-218.
16. 方友强, 邱剑光, 吴杰英, 等.输尿管镜与后腹腔镜手术治疗输尿管上段结石的疗效比较.中华腔镜泌尿外科杂志(电子版), 2012, 6(2):24-27.
17. 敖劲松, 汪波, 邱承俊, 等.输尿管镜与后腹腔镜手术治疗输尿管上段结石的疗效比较.中华腔镜泌尿外科杂志(电子版), 2013, 7(4):289-291.
18. Fang YQ, Qiu JG, Wang DJ, et al. Comparative study on ureteroscopic lithotripsy and laparoscopic ureterolithotomy for treatment of unilateral upper ureteral stones. Acta Cir Bras, 2012, 27(3):1678-1684.
19. Abbas B, Nasser S, Amirmohsen Z, et al. Retrograde, Antegrade, and Laparoscopic Approaches for the Management of Large, Proximal Ureteral Stones:A Randomized Clinical Trial. J Endourology, 2008, 22(12):2677-2680.
20. Wang YY, Hou JQ, Wen DG, et al. Comparative analysis of upper ureteral stones(>15 mm) treated with retroperitoneoscopic ureterolithotomy and ureteroscopic pneumatic lithotripsy. Int Urol Nephrol, 2010, 42(19):897-901.
21. Leonardo C, Simone G, Rocco P, et al. Laparoscopic ureterolithotomy:minimally invasive second line treatment. Int Urol Nephrol, 2011, 43(3):651-654.
22. Farooq SJ, Khan N, Khan M. Retroperitoneal laparoscopic ureterolithotomy-a single centre 10 year experience. Int J Surg, 2011, 9(2):160-164.
23. Flasko T, Holman E, Kovacs G, et al. Laparoscopic ureterolithotomy:the method of choice in selected cases. J Laparoendosc Adv Surg Tech A, 2005, 15(2):149-152.

Chinese Journal of Evidence-Based Medicine

Effectiveness and Safety of Ureteroscopy Surgery in Treatment of Upper Ureteral Calculi: A Meta-Analysis

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