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Treatment of Moderate-sized Kidney Stone with Third-generation Electromagnetic Shock Wave Lithotripter
- Source :
- Open Access Macedonian Journal of Medical Sciences; Vol. 8 No. B (2020): B-Clinical Sciences; 851-857
- Publication Year :
- 2020
- Publisher :
- Scientific Foundation SPIROSKI, 2020.
-
Abstract
- BACKGROUND: The extracorporeal shock wave lithotripsy (ESWL) is a non-invasive method in the treatment of urinary tract stones and its discovery has led to a complete change in the therapeutic strategy for urolithiasis. Due to the low morbidity and excellent fragmentation of the stones, ESWL has proven to be an effective and non-invasive method in the treatment of renal stones. AIM: The aim of this retrospective study is to evaluate the efficacy and safety of the ESWL as a monotherapy in the treatment of moderate size kidney stones with stone area (SA) of 100–300 mm². MATERIALS AND METHODS: We made a retrospective study of 98 patients with moderate size kidney stones with SA of 100–300 mm², divided into two subgroups, into a group with a SA of 100–200 mm² and with 200–300 mm², treated with ESWL in the period of November 2018–December 2019. The patients were treated with a third-generation electromagnetic lithotripter (Lithoskop®, Siemens Medical Systems, Erlangen, Germany), with a source of electromagnetic shocks (Pulso™) and dual ultrasonographic/fluoroscopic system for detection of the stones. The stone location, size, maximum energy used, localization technique, number of shock waves, sessions, re-treatment rate, and additional procedures were reviewed. All the patients before the intervention had a complete laboratory and radiological examinations. Postoperatively, patients were monitored on the 1st, 30th, and 90th post-operative days. RESULTS: Ninety-eight patients with solitary kidney stone with a SA of 100–300 mm² were treated with ESWL. The study included 58 men (59.18%) and 44 women (40.81%). The average length and width of the stone were 15.47 ± 2.68 mm and 12.99 ± 2.83 mm, respectively. The average surface area of the stones in our series was 203.78 ± 72.85 mm². The mean number of treatments for the entire series of patients was 1.82 ± 0.91. The mean number of shock waves for the total series of patients was 3899.11 ± 40. The mean energy used for the overall patient series was 110106.17 ± 21489.61 mJ. The total re-treatment rate was 47.95%. The entire rate of additional procedures was 19.38%. The overall success rate (SR) in our study was 77.55%. The efficiency quotient for the upper-middle and lower calyx was 55.57, 57.15, and 30.81, respectively. CONCLUSION: ESWL is a safe and effective method in the treatment of renal stones, and we recommend as the first method in the treatment of moderate size kidney stone with a surface area of 100–300 mm². The treatment of each patient should be individualized and take into account all favored and non-favored factors that influence the decision to choose extracorporeal lithotripsy as a method of treatment of medium-sized stones.
- Subjects :
- business.industry
moderate sized renal stone
Solitary kidney
medicine.medical_treatment
electromagnetic shock wave lithotripter
Urinary tract stones
030209 endocrinology & metabolism
Retrospective cohort study
General Medicine
medicine.disease
Extracorporeal shock wave lithotripsy
renal stones
Third generation
03 medical and health sciences
0302 clinical medicine
Shock wave lithotripter
Medicine
Kidney stones
030212 general & internal medicine
business
Nuclear medicine
ESWL
nephrolithiasis
Extracorporeal lithotripsy
Subjects
Details
- ISSN :
- 18579655
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Open Access Macedonian Journal of Medical Sciences
- Accession number :
- edsair.doi.dedup.....5865e56bcb263257cb1c4882529e871d