PMID- 36656331 OWN - NLM STAT- MEDLINE DCOM- 20230224 LR - 20230327 IS - 1433-8726 (Electronic) IS - 0724-4983 (Linking) VI - 41 IP - 2 DP - 2023 Feb TI - Assessment of single-probe dual-energy lithotripters in percutaneous nephrolithotomy: a systematic review and meta-analysis of preclinical and clinical studies. PG - 551-565 LID - 10.1007/s00345-023-04278-2 [doi] AB - PURPOSE: To evaluate the safety and efficacy of single-probe dual-energy (SPDE) lithotripters in patients undergoing percutaneous nephrolithotripsy (PCNL) through a systematic review and meta-analysis. METHODS: We searched PubMed, Cochrane Library, Scopus and Embase databases until July 2022 for any preclinical or clinical studies, exploring the safety and efficacy of different SPDE lithotripters in patients undergoing PCNL. We performed a meta-analysis to compare stone-free rate, bleeding, or other complications and mean operative time between SPDE lithotripters and other lithotripters (PROSPERO: CRD42021285631). RESULTS: We included 16 studies (six preclinical, seven observational and three randomized with 625 participants) in the systematic review and four in the meta-analysis. Preclinical studies suggest that SPDE lithotripters are safe and effective for the management of renal stones. Among clinical studies, four studies assessed Trilogy with no comparative arm, two compared Trilogy or ShockPulse with a dual-probe dual-energy lithotripter, two compared Trilogy with a laser, one compared ShockPulse with a pneumatic lithotripter, and one directly compared Trilogy with ShockPulse. Comparing SPDE lithotripters to other lithotripters, no significant differences were demonstrated in stone free rate (OR 1.13, 95% CI 0.53-2.38, I(2) = 0%), postoperative blood transfusion (OR 1.33, 95% CI 0.34-5.19, I(2) = 0%), embolization (OR 0.45, 95% CI 0.02-12.06), operative time (WMD: 2.82 min, 95% CI -7.31-12.95, I(2) = 78%) and postoperative complications based on the Clavien-Dindo classification. CONCLUSIONS: SPDE lithotripters represent a promising treatment modality for patients requiring PCNL. Despite the initial encouraging findings of preclinical and isolated clinical studies, it seems that Trilogy or ShockPulse provide similar efficiency compared to older generation devices. CI - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Mykoniatis, Ioannis AU - Mykoniatis I AD - First Department of Urology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece. AD - Young Academic Urologists (YAU), Urolithiasis and Endourology Working Party, Arnhem, the Netherlands. FAU - Pyrgidis, Nikolaos AU - Pyrgidis N AD - Department of Urology, University Hospital, LMU Munich, Munich-Marchioninistr. 15, 81377, Munich, Germany. FAU - Tzelves, Lazaros AU - Tzelves L AD - Second Department of Urology, Sismanoglio Hospital, Sismanogliou 37, Athens, Greece. AD - University College of London Hospitals NHS Foundation Trust, London, UK. AD - Young Academic Urologists (YAU), Urolithiasis and Endourology Working Party, Arnhem, the Netherlands. FAU - Pietropaolo, Amelia AU - Pietropaolo A AD - Department of Urology, University of Hospital Southampton NHS Trust, Southampton, UK. AD - Young Academic Urologists (YAU), Urolithiasis and Endourology Working Party, Arnhem, the Netherlands. FAU - Juliebo-Jones, Patrick AU - Juliebo-Jones P AD - Department of Urology, Haukeland University Hospital, Bergen, Norway. AD - Young Academic Urologists (YAU), Urolithiasis and Endourology Working Party, Arnhem, the Netherlands. FAU - De Coninck, Vincent AU - De Coninck V AD - Department of Urology, AZ Klina, Brasschaat, Belgium. AD - Young Academic Urologists (YAU), Urolithiasis and Endourology Working Party, Arnhem, the Netherlands. FAU - Hameed, Belthangady M Zeeshan AU - Hameed BMZ AD - Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India. AD - Young Academic Urologists (YAU), Urolithiasis and Endourology Working Party, Arnhem, the Netherlands. FAU - Chaloupka, Michael AU - Chaloupka M AD - Department of Urology, University Hospital, LMU Munich, Munich-Marchioninistr. 15, 81377, Munich, Germany. FAU - Schulz, Gerald Bastian AU - Schulz GB AD - Department of Urology, University Hospital, LMU Munich, Munich-Marchioninistr. 15, 81377, Munich, Germany. FAU - Stief, Christian AU - Stief C AD - Department of Urology, University Hospital, LMU Munich, Munich-Marchioninistr. 15, 81377, Munich, Germany. FAU - Kallidonis, Panagiotis AU - Kallidonis P AD - Department of Urology, University of Patras, Patras, Greece. FAU - Somani, Bhaskar K AU - Somani BK AD - Department of Urology, University of Hospital Southampton NHS Trust, Southampton, UK. FAU - Skolarikos, Andreas AU - Skolarikos A AD - Second Department of Urology, Sismanoglio Hospital, Sismanogliou 37, Athens, Greece. andskol@yahoo.com. LA - eng PT - Journal Article PT - Meta-Analysis PT - Review PT - Systematic Review DEP - 20230119 PL - Germany TA - World J Urol JT - World journal of urology JID - 8307716 SB - IM MH - Humans MH - *Nephrolithotomy, Percutaneous/adverse effects MH - *Kidney Calculi/surgery MH - *Lithotripsy/adverse effects MH - Postoperative Complications/etiology MH - Operative Time MH - Treatment Outcome MH - *Nephrostomy, Percutaneous OTO - NOTNLM OT - Meta-analysis OT - Percutaneous nephrolithotripsy OT - Renal stones OT - Single-probe dual-energy lithotripters OT - Systematic review EDAT- 2023/01/20 06:00 MHDA- 2023/02/25 06:00 CRDT- 2023/01/19 11:14 PHST- 2022/11/26 00:00 [received] PHST- 2022/12/30 00:00 [accepted] PHST- 2023/01/20 06:00 [pubmed] PHST- 2023/02/25 06:00 [medline] PHST- 2023/01/19 11:14 [entrez] AID - 10.1007/s00345-023-04278-2 [pii] AID - 10.1007/s00345-023-04278-2 [doi] PST - ppublish SO - World J Urol. 2023 Feb;41(2):551-565. doi: 10.1007/s00345-023-04278-2. Epub 2023 Jan 19.