Comparison of Extracorporeal Shock Wave Lithotripsy Success Rates Between Ultrasound Targeting and X-ray Targeting

Year 2023, , 109 - 114, 30.09.2023

Sarp Keskin , Ferhat Keser

https://doi.org/10.54233/endouroloji.20231503-1330075

Abstract

Objective: This retrospective study aims to compare the success rates of shock wave lithotripsy (SWL) using
ultrasound (US) targeting versus X-ray targeting.
Material and Methods: A retrospective chart review was conducted on patients who underwent SWL for
urinary tract stones between January 1, 2018, and December 31, 2020. The patients were divided into two
groups based on the imaging modality used for stone targeting during SWL: the US group and the X-ray
group. The success rates of SWL, defined as complete stone clearance or clinically insignificant residual
fragments (<4mm), were compared between the two groups.
Results: A total of 200 patients were included in the study, with 100 patients in each group. The demographics
and stone characteristics of the patients were similar between the two groups. The success rate of SWL in
the US group was 84%, compared to 72% in the X-ray group (p=0.041). The odds ratio for success in the US
group compared to X-ray group was 2.04 (95% confidence interval: 1.02-4.07)
Conclusion: This retrospective study suggests that SWL with US targeting may have a higher success rate
compared to X-ray targeting. US provides a safe and effective alternative for stone targeting during SWL,
avoiding the use of ionizing radiation. Further research is warranted to confirm these findings and explore
the potential benefits of US guided SWL in clinical practice.

Keywords

extracorporeal shock wave lithotripsy, ultrasound, x-ray, urinary stone, fluoroscopy

Ethical Statement

Oxford University Hospitals Ethics Committee (approval reference number: 1249/23, decision date: 21.05.2021)

Vücut Dışı Şok Dalgası İle Taş Kırma Başarısında Ultrason Kılavuzluğu ile X Işını Kılavuzluğunun Karşılaştırılması

Abstract

Amaç: Bu retrospektif çalışmanın amacı, vücut dışı şok dalgası ile taş kırma (SWL) başarısında ultrason (USG)
ile hedefleme ve X ışını ile hedeflemeyi karşılaştırmaktır.
Gereç ve Yöntemler: Ocak 2018 ile Aralık 2020 tarihleri arasında üriner sistem taş hastalığı için SWL
uygulanan hastaların dosyaları geriye dönük olarak incelendi. Hastalar, SWL sırasında taş hedefleme için
kullanılan görüntüleme yöntemine göre iki gruba ayrıldı: USG grubu ve X ışını grubu. SWL başarısı, taşların
tamamen temizlenmesi veya klinik olarak önemsiz, rezidü fragmanların olması (<4 mm) olarak tanımlandı
ve başarı oranı iki grup arasında karşılaştırıldı.
Bulgular: Çalışmaya her grupta 100 hasta olmak üzere toplam 200 hasta dahil edildi. İki gruptaki hastaların
demografik verileri ve taş özelllikleri benzerdi. SWL’nin başarı oranı USG grubunda %84 iken, X ışını grubunda
%72 idi (p=0,041). USG grubunda taşsızlık elde etme ihtimali, X ışını grubuna göre 2,04 (%95 GA: 1,02-4,07)
kat fazlaydı.
Sonuç: Bu retrospektif çalışma, USG hedeflemesiyle yapılan SWL’nin, X ışını hedeflemeli SWL’ye kıyasla daha
yüksek bir başarı oranına sahip olabileceğini önermektedir. USG kılavuzluğu, SWL sırasında taş hedefleme
için iyonize radyasyon kullanmadan güvenli ve etkili bir alternatif sunmaktadır. Bu bulguları doğrulamak ve
klinik pratikte USG kılavuzluğunda SWL’nin potansiyel faydalarını araştırmak için daha fazla çalışmaya ihtiyaç
vardır.

Keywords

vücut dışı şok dalgası ile taş kırma, ultrason, X ışını, üriner taş hastalığı, floroskopi

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