medigraphic.com
Órgano Oficial de el Colegio Mexicano de Urología

2007, Number 3

<< Back Next >>

Bol Col Mex Urol 2007; 22 (3)

Eficacia y morbilidad de la litotricia láser flexible en el manejo de litos renales

López RF, Maldonado AE, Serrano BEA, Montoya MG

Language: Spanish
References: 17
Page: 104-107
PDF size: 46.60 Kb.


ABSTRACT

Introduction: The procedures opened for the handling of the renal calculi reserve for cases with anatomical variables of the patient and the renal unit who diminish the effectiveness of the surgery of minimum invasion. The use of flexible ureteroscopy + laser lithotripsy apparently offers a resolution of the renal calculi in 87% of the cases. Objective: To determine the effectiveness and the incidence of complications of flexible ureteroscopy + laser lithotripsy for the resolution of smaller renal calculi of 1.5 cm. Material and methods: We carried out clinical, longitudinal, observational and descriptive a study. From September of 2006 to August of 2007 34 patients with renal calculi smaller to 15 mm submissive flexible ureteroscopy + laser lithotripsy. The effectiveness for renal calculi in any pielocalicial location ≤ 15 mm was of 85.3%. The treatment success was observed in patients with infundibulopelvic angle open, of 79.6o vs. 70o (p = 0.043) and with short infundibular length, of 28.9 vs. 36.4 mm (p = 0.017). Only there was a patient (2.9%) with ureteral perforation at level of superior third that was solved with positioning of catheter double J by two weeks. Conclusions: Flexible ureteroscopy + laser lithotripsy showed to have a suitable effectiveness for the handling of the renal calculi smaller to 15 mm with a low rate of complications


REFERENCES

  1. Kupeli B, Biri H, Sinik Z, Karaca K, Tuncayegin A, Karaoglan U, Bozkirli I. Extracorporeal shock wave lithotripsy for lower caliceal calculi. Eur Urol 1998; 34: 203-6.

  2. Ramakumar S, Seguea JW. Renal calculi. Percutaneous management. Urol Clin North Am 2000; 27: 617-22.

  3. Tawfiek ER, Bagley DH. Management of upper urinary tract calculi with ureteroscopic techniques. Urology 1999; 53: 25-31.

  4. Bichler KH, Lahme S, Strohmaier WL. Indications for open stone removal of urinary calculi. Urol Int 1997; 59: 102-8.

  5. Paik ML, Wainstein MA, Spirnak P, Hample N, Resnick MI. Current indications for open stone surgery in the treatment of renal and ureteral calculi. J Urol 1998; 159: 374-37.

  6. Baltaci S, Köhle R, Kunit G, Joos H, Frick J. Long-term followup after extracorporeal shock wave lithotripsy of large kidney stones. Eur Urol 1992; 22: 106-11.

  7. Michaels E, Fowler J. ESWL monotherapy for large volume renal calculi: efficacy and morbidity. Urology 1989; 34: 96-9.

  8. Feng MI, Tamaddon K, Mikhail A, Kaptein JS, Bellman GC. Prospective randomized study of various techniques of percutaneous nephrolithotomy. Urology 2001; 58: 345-50.

  9. Albala DM, Assimos DG, Clayman RV, Denstedt JD, Grasso M, Gutierrez-Aceves J, et al. Lower pole I: a prospective randomized trial of extracorporeal shock wave litotripsy and percutaneous nephrostolithotomy for lower pole nephrolithiasis, initial results. J Urol 2001; 166: 2072.

  10. 10.Keeley FX Jr, Moussa SA, Smith G, Tolley DA. Clearance of lower-pole stones following shock wave lithotripsy: Effect of the infundibulopelvic angle. Eur Urol 1999; 36: 371-5.

  11. 11.Ather MH, Abid F, Akhtar S, Khawaja K. Stone clearance in lower pole nephrolithiasis after extra corporeal shock wave lithotripsy - the controversy continues. BMC Urol 2003; 3: 1-8.

  12. 12.Grasso M, Conlin M, Bagley D. Retrograde ureteropyeloscopic treatment of 2 cm or greater upper urinary tract and minor staghorn calculi. J Urol 1998; 160: 346-51.

  13. 13.Gould DL. Retrograde flexible ureterorenoscopic holmium- YAG laser lithotripsy: the new gold standard. Tech Urol 1998; 4: 22-4.

  14. 14.Campbell’s Urología. 8a Ed. Editorial Panamericana; 2004.

  15. 15.Preminger MSPG. Holmium laser for Stone management. World J Urol 2007; 25: 235-9.

  16. 16.Pearle SM, Lingeman EJ, Leveillee R. Prospective, randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less. J Urol 2005; 173: 2005-9.

  17. 17.Preminger MG. Management of lower pole renal calculi: shock wave lithotripsy versus percutaneous nephrolithotomy versus flexible ureteroscopy. Urol Res 2006; 34: 108-11.




2020     |     www.medigraphic.com