Is the Success of Shock Wave Lithotripsy Different in Preschool and School Age Children?

Abstract

Objective: The aim of this study was to retrospectively compare the efficacy and safety of shock wave lithotripsy (SWL) in preschool (0-7 years) and school age (8-16) period.

Material and Methods: The data of 283 pediatric patients under the age of 16 years who were treated with SWL between January 2014 and January 2018 were analyzed retrospectively. The patients were divided into two groups as preschool (Group 1, <7 years) and school age (Group 2, 7-16 years). The diagnosis was made by direct urinary tract X-ray, ultrasonography, intravenous urography and/or reduced-dose non-contrast computed tomography. The groups were evaluated in terms of success, focusing method, stone localization, size, opacity and complications.

Results: Of the 283 pediatric patients, 166 (58.6%) were male and 117 (41.4%) were female. SWL success rates were 127/132 (96.2%) in group 1 and 136/151 (90.1%) in group 2. In 108 patients (81.8%) and 93 (61.6%) patients in group 2, stone sizes were less than 10 mm. The ratio of opaque / non-opaque stones in groups 1 and 2 was respectively 54 (40.9%) / 78 (59.1%) and 104 (68.9%) / 47 (31.1%). Complications were observed in 5 patients (3.8%) of group 1 and 6 (4%) patients in group 2.

Conclusion: Although there are many alternative methods of treatment for stone disease in childhood, SWL is still used as a first-line treatment option in appropriate cases currently. In the preschool period, the passage and clearance of the broken stone fragments is easier than in the school age period and increases the success of SWL. In the treatment of urinary tract stone disease in preschool children, SWL is more successful than school-age children. This will be better elucidated by larger randomized prospective patient series.

Keywords

• Shock wave,lithotripsy,pediatric,stone disease

OKUL ÖNCESİ VE OKUL ÇAĞI ÇOCUKLARDA ŞOK DALGA LİTOTRİPSİ BAŞARISI FARKLI MI?

Abstract

Amaç: Bu çalışmamızdaki amaç, okul öncesi (0-7 yaş) ve okul çağı (8-16) dönemindeki böbrek taşı tedavisinde şok dalga litotripsi (SWL) etkinliğinin ve güvenilirliğinin retrospektif olarak karşılaştırılmasıdır.

Gereç ve Yöntemler: Ocak 2014 - Ocak 2018 tarihleri arasında böbrek taşı olan ve SWL ile tedavi edilen 16 yaşından küçük toplam 283 çocuk hastanın verileri retrospektif olarak incelendi. Hastalar okul öncesi (Grup 1, <7 yaş) ve okul çağı (Grup 2, 7-16 yaş) olmak üzere iki gruba ayrıldı. Tanı, direkt üriner sistem grafisi, ultrasonografi, intravenöz ürografi ve/veya azaltılmış doz kontrastsız bilgisayarlı tomografi ile konuldu. Gruplar; başarı, odaklama yöntemi, taş lokalizasyonu, boyut, opasite ve komplikasyonlar açısından değerlendirildi.

Bulgular: İki yüz seksen üç çocuk hastanın 166 (%58.6)’sı erkek 117 (%41.4)’si ise kız idi. SWL başarı oranları grup 1’de 127/132 (%96.2) ve grup 2’ de 136/151 (%90.1) olarak belirlendi. Grup 1’de 108 (%81.8) ve grup 2’de 93 (%61.6) hastada taş boyutlarının ≤ 10 mm olduğu belirlendi. Sırasıyla 1. ve 2. gruplarda opak / non-opak taş oranı; 54 (%40.9) / 78 (%59.1) ve 104 (%68.9) / 47 (%31.1) idi. Grup 1’de 5 (%3.8), grup 2’de ise 6 (%4) hastada komplikasyon izlendi.

Sonuç: Çocukluk çağında görülen taş hastalığında tedavi için birçok alternatif tedavi yöntemi olmasına rağmen, SWL hala güncelliğini korumakta ve uygun olgularda hala ilk basamak tedavi seçeneği olarak kullanılmaktadır. Okul çağı dönemine göre okul öncesi dönemde, kırılan taş fragmanlarının pasajı ve temizlenmesi daha kolaydır ve SWL başarısını arttırmaktadır. Okul öncesi çocuklardaki üriner sistem taş hastalığının tedavisinde SWL, okul çağındaki çocuklardan daha başarılıdır. Randomize prospektif daha büyük hasta serileri ile bu durum daha iyi aydınlatılabilecektir.

Keywords

• şok dalga,litotripsi,pediatrik,taş hastalığı

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