Adame Martínez J.L., Sánchez Puente J.C., Aragón TAJL, Castillo CG

Language: Spanish
References: 17
Page: 17-21
PDF size: 193.05 Kb.

ABSTRACT

Extracorporeal Shock Wave Lithotripsy is the therapy preferred for must patients with renal calculi due to its noninvasive, minimal anesthesia requirements and high level of patient and physician acceptance. Despite the dominant position of ESWL in the management of urolithiasis, the procedure is not uniformly successful for all types of kidney stones problems.
Materials and Methods. We retrospectively reviewed the record of patients who underwent to Percutaneous Nephrolithotripsy and patients underwent to Extracorporeal Shock Wave Lithotripsy for lower pole renal calculi, between June 2003 to June 2005. Information retrieved included sex, age, side, size stone, location, pre-treatment, need for treatment secondary, procedure immediate treatment results, length of hospitalization and complications.
Results. We have treated 180 patients with percutaneous nephrolithotripsy. The stones were located in pelvis 75 (42%), caliz lower 65 (36%), upper 10 (6%), medium 8 (4%), multiple 18 (10%) and staghom 4 (2%). Of 65 patients with lower pole caliceal stones, 61 (93%) were stone free. Of 110 patients who underwent Extracorporeal Shock Wave Lithotripsy treatment for lower pole renal stones 65 (61%) were stone free. The morbidity of patients underwent Percutaneous Nephrolithtotripsy was minimal with a mean hospital stay of 24-48 hours.
Conclusions. Percutaneous Nephrolithotripsy hadsignificantly better results relative to extracorporeal Shock Wave Lithotripsy, particulary lower pole renal stones larger than 10 mm.

REFERENCES

1. AIken P, Hutschenreiter G, Gunther R, Marberger M. Percutaneous stones manipulation. J Urol. 1981;125: 263-6.

2. Lingeman JE, Siegel YI, Steele B, et al. Management of lower - pole nephrolithiasis. A critical analysis. J Urol. 1994;151:663-667. Adame MJL y cols. Eficacia de la nefrolitotomía percutánea versus litotripsia extracorpórea. Cuadro 5. Informe de éxito en diferentes litotriptores en litos de cáliz inferior.2 Litotriptor Libre de litos, Núm. / Total (%) HM3 1190 / 1860 (63) Lithostar 497 / 979 (50)MFL 5000 46 / 88 (52)

3. Chadhoke PS. Cost-effectiveness of different treatment options for stag hom calculi. J Urol. 1996;156: 1567-1571.

4. Cohen TD, Preminger GM. Management of calyceal calculi (review): Urol Clin North Am. 1997;24:81-96.

5. Dushinski JW, Lingeman JE. Simultaneous bilateral percutanea nephrolithotomy. J Urol. 1997;158:2065-2068.

6. Munver R, Delvecchio F, Neuwman G, Preminger G. Critical analysis of supracostal access for percutaneous renal surgery, J Urol. 2001;166:1242-6.

7. Lam HS, Lingeman JE, Barron M. Staghom calculi: analysis of treatment results between initial percutaneous nephrostolithotomy and extracorporeal shock wave lithotripsy monotherapy with reference to surface area. J Urol. 1992;147:1219-1225.

8. Renner Ch, Rassweiler J. Treatment of renal stone by extracorporeal shock wave lithotripsy. Nephron. 1999; 81 (suppl):71-81.

9. Riddeil, Jonathan VB, Denstedt, John D. Prospective randomized trial of ESWL and PCLN for lower pole nephrolithiasis; financial subanalysis. J Urol. 1999; 161(4S) Suppl: 369.

10. Redecka E, Magnusson A. Complications Associated with Percutaneous Nephrostomies. A Retrospective Study. Acta Radiol. 2003;44:447-451.

11. Jones JA, Lingeman JE, Steidle CP. The roles of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy in the management of pyelocaliceal diverticula. J Urol. 1991;146:724.

12. Coloby, Patrick J, Abdelwahab A. Mobile lithotripsy with the new technomed lithotripter Sonolith 4000. A new cost effective mobile ESWL concept. Br J Urol. 1997;80 (suppl):335.

13. Adame, et al. Eficacia de NLPC vs LEOCH en litiasis del cáliz inferior, pág. 9.

14. Liou, Louis S, Streem, Stevan B. Long-term renal functional effects of shock wave lithotripsy, percutaneous nephrolithotomy and combination therapy. A comparative study of patients with solitary kidney. J Urol. 2001;166:33-37.

15. Sfívastava A, Zaman W, Mandhani V, Kumar A, Singh U. Efficacy of extracorporeal shock wave lithotripsy for solitary lower calyceal stone: a statistical model. Br J Urol. 2004;93:364-368.

16. Pardalidis N, Kosmaoglou E, Papatsoris A, Andriopoulos N, Michalakis. Percutaneous nepholithotripsy of multiple calyceal calculi. Br J Urol. 2004;94 (Suppl):13.

17. Chiang E, Tay Poh Hwe S, Mankay L, Shen Lian, Kamara R, Varanathan N. Randomized controlled study of mechanical percussion, diuresis and inversion therapy to assist passage of lower pole renal calculi after shock wave lithotripsy. Urology. 2005;65:1070.