Owen K. et al., 2023: Role of Noncontrast Computed Tomography Parameters in Predicting the Outcome of Extracorporeal Shock Wave Lithotripsy for Upper Urinary Stones Cases: A Meta-analysis.

Owen K, Joe W, Ivander A, Palgunadi IN, Adhyatma KP.
Bangli General Hospital, Bangli, Indonesia (K.O.). Electronic address: This email address is being protected from spambots. You need JavaScript enabled to view it..
Regional Public Hospital dr.M. Thomsen Nias, Gunungsitoli, Indonesia (W.J.).
Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia (A.I.).
Urology Division, Bangli General Hospital, Bangli, Indonesia (I.P.).
Department of Surgery, Urology Division, Universitas Sumatera Utara, Medan, Indonesia (K.P.A).

Abstract

Rationale: Extracorporeal shock wave lithotripsy (ESWL) is widely considered the primary approach for managing urinary tract stones. This study aimed to assess the predictive factors associated with non-contrast computed tomography (NCCT)-based parameters of upper urinary stones in relation to the outcomes of ESWL.

Materials and methods: A systematic search was conducted in PubMed, ScienceDirect, Web of Science, and Cochrane Library to identify all relevant studies published up to June 3, 2023. Several NCCT-based parameters to predict ESWL outcomes, comprised of mean stone density (MSD), skin-to-stone distance (SSD), and stone size, were extracted and analyzed using Review Manager software.

Results: Out of 979 publications screened, a total of 39 publications, involving 7869 patients, were enrolled in the analysis. The pooled estimate demonstrated significant differences between MSD, and stone size between successful and failure of stone fragmentation groups, in which lower values of these parameters are associated with successful ESWL outcomes.

Conclusion: The results from the current study suggested that lower NCCT parameters, notably MSD, SSD, and stone size, are significantly associated with successful ESWL outcome. However, additional large-scale prospective studies are required to utilize these parameters effectively, and the optimal cutoff value should be determined.

Acad Radiol. 2023 Nov 18:S1076-6332(23)00556-1. doi: 10.1016/j.acra.2023.10.021. Online ahead of print. PMID: 37985292 Review.