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The efficiency of new generation ESWL device at lower calyx urinary stones

Year 2014, Volume: 6 Issue: 1, 11 - 14, 01.04.2014

Abstract

Aim: To investigate the efficiency of new generation ESWL devices for the treatment of lower calyx urinary stones with data review of previous patients Method: One hundred fifty one procedures of ESWL performed by new generation electromagnetic Storz Medical Modulith SLK ESWL device were evaluated retrospectively This study contains data from 94 male and 57 female patients whose admitted to Hisar Intercontinental Hospital between January 2009 and February 2012. Ages of patients were between 13-79 mean: 41year . The diameters of stones were between 7-20 mm mean 12mm .An average 1000-3500 shock waves mean: 2500 were used for each ESWL session. The procedure was accepted successful with less than 3 mm or smaller remnant stones within the following 3 months interval. Results: Hundred thirty-three stones of 151 lower calyx stones 88.1% were removed. Remaining 18 stones 11.9% were treated with flexible ureterorenoscopy URS due to unsuccessful fragmentation and/or residual stones. No analgesia was required for 140 92.8% patients. Intravenous Tramadol was administered to 4 2.6 % and intramuscular Diclophenac administered to 7 4.6% patients. No spinal or epidural anaesthesia, sedation or narcotic analgesics were used. Haematuria was observed in 110 72.8% patients as a minor complication. As major complication, a perianal haematoma was seen in one patient, stone street which required URS was developed at three patients, but the complication rates were less than invasive stone treatment methods Conclusion: New Generation ESWL was found efficient and safe for the treatment of lower calyx stones of 2 cm or less.

References

  • Chaussy C, Brendel W, Schmiedt E. Extracorpo- really induced destruction of Kidney stones by shock waves. Lancet 1980;2:1265–1268.
  • Göğüş Ç. Böbrek Alt Kalis Taşlarında Tedavi. Tur- kiye Klinikleri J Surg Med Sci 2006, 2(4):10-12
  • May DJ, Chandroke PS. Efficacy and cost effec- tiveness of ESWL for solitary pole renal calculi. J Urol 1998;159:24-27.
  • Günlüsoy B, Değirmenci T, Yener H, Nergiz N, Minareci S, Ayder AR. İzole Alt Kaliks Taşlarının Beden Dışı Şok Dalga ile Taş Kırma (ESWL) Teda- visinde İnfundibulopelvik Anatominin ve Açının Etkileri. Türk Üroloji Dergisi 2005;31(2):240-245
  • Saw KC, Lingeman JE. Management of calyceal Stones. AUA Update Series 1999;18:154-159.
  • Odabaş Ö, Akyol C, Aydın S,Yılmaz Y. ESWL Mo- noterapisi: 340 Hastadaki Sonuçlarımız (ESWL Monotherapy: Our Results in 340 Patients). Türk Üroloji Dergisi 1996; 2(2):125-126.
  • Taş S, Tuğcu V, Mutlu B, Kalfazade N, Bitkin A, Taşçı Aİ. Kliniğimizde Üroloji asistanlarınca uygu- lanan ESWL tedavi sonuçları. The New Journal of Urology 2011; 6 (1): 13-17.
  • Danuser H, Müller R, Descoeudres B, Dobry E, Studer UE. Extracorporeal Shock Wave Lithot- ripsy of Lower Calyx Calculi: How Much Is Tre- atment Outcome Influenced by the Anatomy of the Collecting System. European Urology 2007;52(2):307-622.
  • Sampaio FJ, D’Anunciação AL, Silva EC. Compa- rative follow-up of patients with acute and obtu- se infundibulum-pelvic angle submitted to extra- corporeal shockwave lithotripsy for lower caliceal stones: preliminary report and proposed study design. J Endourol 1997;11(3):157-161.
  • Elbahnasy AM, Shalhav AL, Hoeing DM et al. Lower calyceal Stone clearance after shock wave lithotripsy or ureteroscopy: The impact of lower pole radiographic anatomy. J Urol 1998;159:676- 682
  • Dhar NB, Thornton J, Karafa MT, Streem SB. A multivariate analysis of risk factors associated with subcapsular hematoma formation fol- lowing electromagnetic shock wave lithotripsy. J Urol 2004; 172: 2271-2274
  • Delius M, Enders G, Xuan ZR, Liebich HG, Brendel W. Biological effects of shock waves: kidney da- mage by shock waves in dogs--dose dependen- ce. Ultrasound Med Biol 1988; 14:117-122
  • Abe H, Nisimura T, Osawa S, Miura T, Oka F. Acu- te pancreatitis caused by extracorporeal shock wave lithotripsy for bilateral renal pelvic calculi. Int J Urol 2000;7:65-68
  • Krambeck AE, Gettman MT, Rohlinger AL, et al. Diabetes mellitus and hypertension associated with shock wave lithotripsy of renal and proxi- mal ureteral stones at 19 years of followup. J Urol 2006;175:1742–1747.

Alt kaliks taşlarında yeni nesil ESWL cihazının etkinliği

Year 2014, Volume: 6 Issue: 1, 11 - 14, 01.04.2014

Abstract

Amaç: Bu çalışmanın amacı retrospektif olarak böbrek alt kaliks idrar taşlarının tedavisinde yeni nesil ESWL cihazların etkinliğini araştırmaktır Metod: Yeni nesil elektromanyetik Storz Medical Modulith SLK ESWL cihazı ile taş tedavisi yapılan 151 hasta retrospektif olarak değerlendirildi. Bu çalışmada Ocak 2009-Şubat 2012 tarihleri arasında Hisar Intercontinental Hastanesi'ne başvuran 94 erkek ve 57 kadın hastanın verileri değerlendirildi. Hastaların yaşları 13-79 ort:41 yıl arasında idi. Taşların çapları 7-20 mm ort:12 mm arasında idi. Her ESWL seansında 1000-3500 ort: 2500 şok dalgası uygulanmıştı. Üç aylık süre içinde en az 3 mm ya da daha küçük fragmanlar olduğu durumda tedavi başarılı kabul edilmiştirsunda Mueller-Hinton agarda disk diffüzyon yöntemi ile araştırılmıştır. Bulgular: Yüz ellibir alt kaliks taşının 133 ünde arınma sağlandı % 88.1 . Kalan 18 taş % 11.9 başarısız parçalanma ve / veya rezidüel taş nedeniyle fleksibl üreterorenoskopi URS ile tedavi edildi. Analjezi 140 % 92.8 hasta için gerekli oldu. Dört hastaya intravenöz Tramadol % 2.6 ve 7 hastaya diklofenak % 4.6 uygulandı. Hiçbir hastaya spinal veya epidural anestezi, sedasyon veya narkotik analjezikler kullanılmadı. Minör komplikasyon olarak 110 hastada % 72.8 hematüri gözlendi. Majör komplikasyon olarak, bir hastada perirenal hematom, üç hastada taş caddesi URS gerekli olmuştur görüldü, ancak genel komplikasyon oranları invazif taş tedavi yöntemlerinden daha düşüktü Sonuç: Yeni nesil ESWL cihazı ile taş tedavisi 2 cm veya daha küçük olan renal kaliks taşlarınında etkili ve güvenli bulunmuştur.

References

  • Chaussy C, Brendel W, Schmiedt E. Extracorpo- really induced destruction of Kidney stones by shock waves. Lancet 1980;2:1265–1268.
  • Göğüş Ç. Böbrek Alt Kalis Taşlarında Tedavi. Tur- kiye Klinikleri J Surg Med Sci 2006, 2(4):10-12
  • May DJ, Chandroke PS. Efficacy and cost effec- tiveness of ESWL for solitary pole renal calculi. J Urol 1998;159:24-27.
  • Günlüsoy B, Değirmenci T, Yener H, Nergiz N, Minareci S, Ayder AR. İzole Alt Kaliks Taşlarının Beden Dışı Şok Dalga ile Taş Kırma (ESWL) Teda- visinde İnfundibulopelvik Anatominin ve Açının Etkileri. Türk Üroloji Dergisi 2005;31(2):240-245
  • Saw KC, Lingeman JE. Management of calyceal Stones. AUA Update Series 1999;18:154-159.
  • Odabaş Ö, Akyol C, Aydın S,Yılmaz Y. ESWL Mo- noterapisi: 340 Hastadaki Sonuçlarımız (ESWL Monotherapy: Our Results in 340 Patients). Türk Üroloji Dergisi 1996; 2(2):125-126.
  • Taş S, Tuğcu V, Mutlu B, Kalfazade N, Bitkin A, Taşçı Aİ. Kliniğimizde Üroloji asistanlarınca uygu- lanan ESWL tedavi sonuçları. The New Journal of Urology 2011; 6 (1): 13-17.
  • Danuser H, Müller R, Descoeudres B, Dobry E, Studer UE. Extracorporeal Shock Wave Lithot- ripsy of Lower Calyx Calculi: How Much Is Tre- atment Outcome Influenced by the Anatomy of the Collecting System. European Urology 2007;52(2):307-622.
  • Sampaio FJ, D’Anunciação AL, Silva EC. Compa- rative follow-up of patients with acute and obtu- se infundibulum-pelvic angle submitted to extra- corporeal shockwave lithotripsy for lower caliceal stones: preliminary report and proposed study design. J Endourol 1997;11(3):157-161.
  • Elbahnasy AM, Shalhav AL, Hoeing DM et al. Lower calyceal Stone clearance after shock wave lithotripsy or ureteroscopy: The impact of lower pole radiographic anatomy. J Urol 1998;159:676- 682
  • Dhar NB, Thornton J, Karafa MT, Streem SB. A multivariate analysis of risk factors associated with subcapsular hematoma formation fol- lowing electromagnetic shock wave lithotripsy. J Urol 2004; 172: 2271-2274
  • Delius M, Enders G, Xuan ZR, Liebich HG, Brendel W. Biological effects of shock waves: kidney da- mage by shock waves in dogs--dose dependen- ce. Ultrasound Med Biol 1988; 14:117-122
  • Abe H, Nisimura T, Osawa S, Miura T, Oka F. Acu- te pancreatitis caused by extracorporeal shock wave lithotripsy for bilateral renal pelvic calculi. Int J Urol 2000;7:65-68
  • Krambeck AE, Gettman MT, Rohlinger AL, et al. Diabetes mellitus and hypertension associated with shock wave lithotripsy of renal and proxi- mal ureteral stones at 19 years of followup. J Urol 2006;175:1742–1747.
There are 14 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Basri Çakıroğlu This is me

Orhun Sinanoğlu This is me

S. Erkan Eyyüpoğlu This is me

Publication Date April 1, 2014
Published in Issue Year 2014 Volume: 6 Issue: 1

Cite

Vancouver Çakıroğlu B, Sinanoğlu O, Eyyüpoğlu SE. Alt kaliks taşlarında yeni nesil ESWL cihazının etkinliği. Maltepe tıp derg. 2014;6(1):11-4.