Abstract
INTRODUCTION: This meta-analysis compares the efficacy and safety of laser lithotripsy (LL) and pneumatic lithotripsy (PL) for upper tract urolithiasis. METHODS: A systematic search of MEDLINE via PubMed, Embase, and the Cochrane Library identified trials comparing LL and PL. Primary outcomes included stone-free rate, operative time, and complications. A random-effects model was used, and heterogeneity was assessed using I2 statistics. RESULTS: The systematic literature search identified 6,420 studies of which 43 fulfilled the inclusion criteria. The studies reported data from 7,377 patients. Random effect meta-analysis for stone free rate included data from 36 studies and yielded statistically significant higher stone free rates for LL with a pooled OR = 2.19 (95% confidence interval [CI] = 1.63-2.94, p < 0.001). Heterogeneity was substantial (I2 = 62%; p < 0.01). Random effect meta-analysis for operative time included data from 31 studies and yielded no statistically significant difference in operative time with a pooled MD = -1.09 min (95% CI = -4.39-2. 20, p = 0.5161). Heterogeneity was considerable (I2 = 98%; p < 0.01). Random effect meta-analysis for complications included data from 14 studies and yielded statistically significant fewer complications for LL with a pooled OR = 0.68 (95% CI = 0.48-0.96, p = 0.0276). Heterogeneity was limited (I2 = 27%; p = 0.17). CONCLUSIONS: LL might be superior to PL in upper tract urolithiasis therapy.