Comparison of efficacy and safety of various management options for large upper ureteric stones a systematic review and network meta-analysis

Abstract To compare the safety and efficacy of various surgical modalities to manage large (> 1 cm) upper ureter stones. Systematic literature search was conducted to include all randomized studies comparing various treatment options for large (> 1 cm) upper ureteric stones. This review includ...

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Autores principales:	Gopal Sharma, Tarun Pareek, Shantanu Tyagi, Pawan Kaundal, Anuj Kumar Yadav, Yashasvi Thummala, Sudheer Kumar Devana
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bb3dffb389b64e2492fc038ac09dc4ac
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spelling	oai:doaj.org-article:bb3dffb389b64e2492fc038ac09dc4ac2021-12-02T15:03:05ZComparison of efficacy and safety of various management options for large upper ureteric stones a systematic review and network meta-analysis10.1038/s41598-021-91364-32045-2322https://doaj.org/article/bb3dffb389b64e2492fc038ac09dc4ac2021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91364-3https://doaj.org/toc/2045-2322Abstract To compare the safety and efficacy of various surgical modalities to manage large (> 1 cm) upper ureter stones. Systematic literature search was conducted to include all randomized studies comparing various treatment options for large (> 1 cm) upper ureteric stones. This review included 13 randomized studies with 1871 patients. Laparoscopic ureterolithotomy (LUL) and percutaneous nephrolithotomy (PNL) were superior to ureteroscopy (URS) and shockwave lithotripsy (SWL) for stone-free rates and need for auxiliary treatments. LUL and PNL were equally effective for stone-free rates and the need for auxiliary treatments. According to SUCRA values for stone-free rates and the need for auxiliary treatments, LUL was the best, followed by PNL. For the duration of surgery, there was no significant difference among all the techniques on network analyses, and SWL was the best according to SUCRA values. Length of hospital stay was significantly shorter for URS than LUL and PNL from network analysis, but there was no significant difference for the rest of the comparisons. Overall complications were similar in all the groups. According to the CINeMa approach, the confidence rating ranged from “very low” to “moderate” for various comparisons. LUL followed by PNL is the most efficacious treatment modality for upper ureteric stones compared to SWL and URS in terms of stone-free rates. However, due to the poor quality of included studies, further high-quality randomized studies are needed.Gopal SharmaTarun PareekShantanu TyagiPawan KaundalAnuj Kumar YadavYashasvi ThummalaSudheer Kumar DevanaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Gopal Sharma Tarun Pareek Shantanu Tyagi Pawan Kaundal Anuj Kumar Yadav Yashasvi Thummala Sudheer Kumar Devana Comparison of efficacy and safety of various management options for large upper ureteric stones a systematic review and network meta-analysis
description	Abstract To compare the safety and efficacy of various surgical modalities to manage large (> 1 cm) upper ureter stones. Systematic literature search was conducted to include all randomized studies comparing various treatment options for large (> 1 cm) upper ureteric stones. This review included 13 randomized studies with 1871 patients. Laparoscopic ureterolithotomy (LUL) and percutaneous nephrolithotomy (PNL) were superior to ureteroscopy (URS) and shockwave lithotripsy (SWL) for stone-free rates and need for auxiliary treatments. LUL and PNL were equally effective for stone-free rates and the need for auxiliary treatments. According to SUCRA values for stone-free rates and the need for auxiliary treatments, LUL was the best, followed by PNL. For the duration of surgery, there was no significant difference among all the techniques on network analyses, and SWL was the best according to SUCRA values. Length of hospital stay was significantly shorter for URS than LUL and PNL from network analysis, but there was no significant difference for the rest of the comparisons. Overall complications were similar in all the groups. According to the CINeMa approach, the confidence rating ranged from “very low” to “moderate” for various comparisons. LUL followed by PNL is the most efficacious treatment modality for upper ureteric stones compared to SWL and URS in terms of stone-free rates. However, due to the poor quality of included studies, further high-quality randomized studies are needed.
format	article
author	Gopal Sharma Tarun Pareek Shantanu Tyagi Pawan Kaundal Anuj Kumar Yadav Yashasvi Thummala Sudheer Kumar Devana
author_facet	Gopal Sharma Tarun Pareek Shantanu Tyagi Pawan Kaundal Anuj Kumar Yadav Yashasvi Thummala Sudheer Kumar Devana
author_sort	Gopal Sharma
title	Comparison of efficacy and safety of various management options for large upper ureteric stones a systematic review and network meta-analysis
title_short	Comparison of efficacy and safety of various management options for large upper ureteric stones a systematic review and network meta-analysis
title_full	Comparison of efficacy and safety of various management options for large upper ureteric stones a systematic review and network meta-analysis
title_fullStr	Comparison of efficacy and safety of various management options for large upper ureteric stones a systematic review and network meta-analysis
title_full_unstemmed	Comparison of efficacy and safety of various management options for large upper ureteric stones a systematic review and network meta-analysis
title_sort	comparison of efficacy and safety of various management options for large upper ureteric stones a systematic review and network meta-analysis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/bb3dffb389b64e2492fc038ac09dc4ac
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Comparison of efficacy and safety of various management options for large upper ureteric stones a systematic review and network meta-analysis

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