A Meta-analysis Of Percutaneous Nephrolithtomy Versus Ureterolithotripsy In The Treatment Of Proximal Ureteral Stones

Objective: To assess the efficacy and safety of percutaneousnephrolithotomy (PCNL) versus Ureterolithotripsy (URL) in the treatmentof proximal ureteral stones.Methods: we electronically searched PubMed, Cochrane library,EMBASE, WanFang and VIP to collecte randomized controlled trials(RCTs) involiving percutaneous nephrolithotomy versus Ureterolithotripsyfor the treatment of proximal ureteral stones. The quality of those trials wereassessed. Data were extracted and analyzed with RevMan5.0software.Results: Seven papers were finally obtained after screening. A total of859patients were included for a meta-analysis. The results showed that, ascompared with the control group (URL), the patients in the trial group(PCNL) had the following features:(1)There was a remarkableimprovement of the stone clearance rate（RR=1.27,95%CI:1.14~1.42，P<0.0001);(2)There was no statistical difference in complication rates andmean mean operative duration（RR=0.5,95%CI:0.19~1.30，P=0.16；WMD =14.16，95%CI:-17.57~45.90，P=0.38）;(3)The hospitalization stay wasdelayed an average of2.3days(RR=2.30,95%CI:0.37~4.24，P=0.002).Conclusion: PCNL is better than URL in the stone clearance rate,meanwhile, there are no significant differences when comparing PCNL andURL in complication rates and mean mean operative duration. However,the PCNL group have to stay in the hospital much longer than URL.