title: Comparison of YAG Laser Lithotripsy and Extracorporeal Shock Wave Lithotripsy in Treatment of Ureteral Calculi: A Meta-Analysis.
abstract: OBJECTIVE
  To evaluate the clinical efficiency and safety of ureteroscopy lithotripsy (URSL) with holmium laser technology and extracorporeal shock wave lithotripsy (ESWL) on ureteral calculi using systematic reviews.
  
  
  METHODS
  Randomized controlled trials and prospective controlled trials accorded with inclusion among PubMed Database, EmBase Database, Cochrane Library and China National Knowledge Infrastructure were collected. Review Manager 5.0 was adopted to estimate the effects of the results among selected articles. Forest plots, sensitivity analysis and bias analysis for the articles included were also conducted. Pooled estimate of risk ratios and standard mean difference (SMD) with 95% CIs were used as measures of effect sizes.
  
  
  RESULTS
  Finally 1,770 patients were included in the 14 studies, which eventually satisfied the eligibility criteria. The number of patients in URSL group and ESWL group were 885 and 885, respectively. The results of heterogeneity test suggested that complication events (RR 1.12 (95% CI 0.63-2.00), p = 0.70), hospital days (SMD = -0.08 (95% CI -1.14 to 0.98), p = 0.88) and efficiency quotient (RR 1.31 (95% CI 0.96-1.80), p = 0.09) were insignificantly different, while the stone-free rate (RR 1.15 (95% CI 1.06-1.26), p = 0.002) and operation time (SMD = -2.27 (95% CI -3.42 to -1.11), p = 0.0001) between ESWL and URSL were significantly different.
  
  
  CONCLUSIONS
  Although both URSL and ESWL have its own advantages and drawbacks, URSL is relatively a more efficient and safe method to treat ureteric stones, since it has shorter operation time and a better stone-free rate.
authors: The National Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China.
authors: Chao
authors: C
authors: Yang
authors: Shijun
authors: S
authors: Li
authors: Yingdong
authors: Y
authors: Cui
mesh_terms: D000465:Algorithms; D002681:China; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State; D008096:Lithotripsy / Q000379:methods*; D017602:Lithotripsy, Laser / Q000379:methods*; D008297:Male; D015233:Models, Statistical; D016017:Odds Ratio; D061646:Operative Time; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000628:therapy*; D018666:Ureteroscopy / Q000379:methods*; D014545:Urinary Calculi / Q000628:therapy*
keywords: Extracorporeal shock wave lithotripsy; Ureteral calculi; Ureteroscopy lithotripsy with holmium laser