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Uncovering the real outcomes of active renal stone treatment by utilizing non-contrast computer tomography: a systematic review of the current literature

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Abstract

Purpose

To evaluate the stone-free rates (SFRs) and stone clearance rates (SCRs) of extracorporeal shock-wave lithotripsy (SWL), retrograde intrarenal surgery (RIRS), and percutaneous nephrolitholapaxy (PCNL) according to non-contrast computer tomography (NCCT) findings.

Methods

Original articles were identified from PubMed. After exclusion of ineligible papers, twenty-three studies with 2494 cases were included in the review.

Results

Six SWL, five RIRS and eight PCNL studies were selected. Additionally, four comparative articles were identified. SWL presents SFRs ranging 35–61.3 % and SCRs for residuals <4 mm being 43.2–92.9 %. RIRS studies report SFRs of 34.8–59.7 % and SCRs for residuals <4 mm ranging 48–96.7 %. Finally, PCNL presents SFRs of 20.8–100 % and SCRs for residuals <4 mm being 41.5–91.4 %. According to the comparative studies, SFRs are 17–61.3 % for SWL, 50 % for RIRS, and 95–100 % for PCNL.

Conclusions

According to NCCT findings, it seems that PCNL provides better SFRs than ESWL and RIRS. However, further research with comparable and complete preoperative parameters and outcomes could reduce the heterogeneity of current data.

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Author’s contribution

T Tokas contributed to project development, data collection, data analysis and manuscript writing. M Habicher contributed to data collection and data analysis. D Junker helped in manuscript editing. T Herrmann contributed to manuscript editing. JP Jessen contributed to manuscript editing. T Knoll helped in manuscript editing. U Nagele contributed to project development and manuscript editing.

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Authors and Affiliations

  1. Department of Urology and Andrology, General Hospital Hall i.T., Milser Str. 10, 6060, Hall in Tirol, Austria

    Theodoros Tokas, Martin Habicher & Udo Nagele

  2. Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria

    Daniel Junker

  3. Department of Urology and Urooncology, Hannover Medical School (MHH), Hannover, Germany

    Thomas Herrmann

  4. Department of Urology, Klinikum Sindelfingen-Böblingen, Sindelfingen, Germany

    Jan Peter Jessen & Thomas Knoll

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  1. Theodoros Tokas
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Training Research in Urological Surgery Technology (T.R.U.S.T.)-Group

Corresponding author

Correspondence to Udo Nagele.

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The authors declare that they have no conflict of interest.

Human and animal rights

This review does not involve human participants and/or animals.

Appendices

Appendix 1

The pubMed search was performed by two independent reviewers (TT, MH) and the keywords used were selected after their consensus and the suggestions of the senior author.

Appendix 2

Criteria for considering studies

  • patients/participants: Healthy non-obese adults (mean age: 29.6–62)

  • interventions: SWL, RIRS and standard PCNL

  • comparators: NCCT

  • outcomes: Stone-free rates and stone clearance rates according to NCCT findings.

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Tokas, T., Habicher, M., Junker, D. et al. Uncovering the real outcomes of active renal stone treatment by utilizing non-contrast computer tomography: a systematic review of the current literature. World J Urol 35, 897–905 (2017). https://doi.org/10.1007/s00345-016-1943-y

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  • DOI: https://doi.org/10.1007/s00345-016-1943-y

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