Clinical Efficacy of Ureteroscopy Versus Laparoscopic Ureterolithotomy in the Treatment of Large Proximal Ureteral Stones (>1 cm): A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Erping Wang, Peng Tang, Chen Chen
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy of ureteroscopy versus laparoscopic ureterolithotomy for treating large proximal ureteral stones (>1 cm) in 1300 patients across 11 randomized controlled trials. Laparoscopic ureterolithotomy demonstrated significantly higher immediate and final stone-free rates (OR = 8.06 and OR = 8.56, respectively) but was associated with longer operative times and increased postoperative pain.
Key findings
- Laparoscopic ureterolithotomy had higher immediate stone-free rates (OR = 8.06, P < .001) compared to ureteroscopy.
- Final stone-free rates were also significantly higher for laparoscopic ureterolithotomy (OR = 8.56, P < .001).
- Patients undergoing laparoscopic ureterolithotomy experienced longer hospital stays (SMD = 1.67, P < .001).
- Postoperative complication rates were significantly lower with laparoscopic ureterolithotomy (OR = 0.43, P < .001).
Why it matters
Understanding the comparative effectiveness of these surgical approaches is crucial for optimizing treatment strategies for patients with large proximal ureteral stones, particularly given the associated risks and recovery profiles.
What to keep in mind
The analysis primarily includes older trials that may not reflect advancements in ureteroscopic technologies.