title: Holmium: YAG laser lithotripsy versus pneumatic lithotripsy for treatment of distal ureteral calculi: a meta-analysis.
abstract: The objective of this study was to estimate the treatment effect of Pneumatic Lithotripsy (PL) versus holmium: YAG laser lithotripsy (LL) in the treatment of distal ureteric calculi. A bibliographic search covering the period from 1990 to April 2012 was conducted using search engines such as MEDLINE, EMBASE, and Cochrane library. Data were extracted and analyzed with RevMan5.1 software. A total of 47 studies were scant, and 4 independent studies were finally recruited. Holmium: YAG LL conveyed significant benefits compared with PL in terms of early stone-free rate [odds ratio (OR)=4.42, 95% confidence interval (CI) (1.14, 17.16), p=0.03], delayed stone-free rate [OR=4.42, 95%CI (1.58, 12.37), p=0.005], mean operative time [WMD=-16.86, 95%CI (-21.33, -12.39), p<0.00001], retaining double-J catheter rate [OR=0.44, 95%CI (0.25, 0.78), p=0.004], and stone migration incidence [OR=0.26, 95%CI (0.11, 0.62), p=0.003], but not yet in the postoperative hematuria rate and the ureteral perforation rate according to this meta-analysis. Precise estimates on larger sample size and trials of high quality may provide more uncovered outcomes in the future.
authors.affiliation: Department of Urology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China.
authors.forename: Xiangrui
authors.initials: X
authors.lastname: Yin
authors.forename: Ziwei
authors.initials: Z
authors.lastname: Tang
authors.forename: Bei
authors.initials: B
authors.lastname: Yu
authors.forename: Yarong
authors.initials: Y
authors.lastname: Wang
authors.forename: Yuehua
authors.initials: Y
authors.lastname: Li
authors.forename: Qi
authors.initials: Q
authors.lastname: Yang
authors.forename: Wei
authors.initials: W
authors.lastname: Tang
mesh_terms: D006417:Hematuria / Q000209:etiology; D006801:Humans; D053844:Lasers, Solid-State; D017602:Lithotripsy, Laser / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000473:pathology / Q000628:therapy*; D062885:Urinary Catheters