The Efficiency Of Holmium Laser Lithotripsy And Pneumatic Lithotripsy For Ureteral Calculi-A Meta Analysis

Objective: To compare the effectiveness of holmium laser lithotripsy(LL) and pneumatic lithotripsy(PL)for ureteral calculi.Methods: A research for articles from Jan. 2005 to May 2015 related to the comparative effectiveness of holmium laser lithotripsy and pneumatic lithotripsy for ureteral calculi was ran on Pub Med, DSpace, ScienceDirect,OVID, EJournals, CNKI and Wanfang. The quality of studies was evaluated according to the Cochrane systematic review guideline and the software Stata11 was used for meta-analysis.Results: A total of 10 articles involving 4004 cases were included, 2079 cases receiving the treatment of pneumatic lithotripsy for ureteral calculi and1925 cases receiving holmium laser lithotripsy. Meta-analysis of these studies showed that the average operative time of LL was shorter than that of PL【 SMD=1.166,95%CI(0.258,2.074),P<0.05 】, there was no significant difference in postoperative hospital stay【Z=1.65,95%CI(-0.115,1.318),P>0.05】and costs【Z=0.17,95%CI(-0.495,0.414),P>0.05】, the average first successful rate of stone fragmentation and the stone postoperative clearance rate of LL were higher than that of PL.Conclusion: For the treatment of ureteral calculi, the average operative time of holmium laser lithotripsy was shorter than that of pneumatic lithotripsy, the average first successful rate of stone fragmentation and the stone postoperative clearance rate of LL were higher than that of PL, but there was no significant difference in postoperative hospital stay and costs.However, a prospective randomized study with a larger sample size and high quality is needed to confirm this result.