The effectiveness of ESWL in the management of lower pole kidney stones

Öz

Objective: The developments in the endourological treatments of urinary system stone diseases led to the discussions about the first choice treatment methods. We have evaluated the results of extracorporeal shock wave treatments being applied in our clinics for the lower pole stones which has the most of the those discussions. Methods: The records of 271 stone patients who were applied ESWL according to CT results between January 2013 and July 2013 to our clinics were examined. In the controls after the procedure, who could not be evaluated with the non-contrast computerized tomography (CT) and ESWL treatment not completed, were excluded from the study. 52 patients with lower pole stone in total were divided into two according to the success of the ESWL treatment. ESWL success or unsuccessful groups, the size of the stone, density of the stone and the distance between the stone and skin was recorded by examining the abdominal non-contrast computed tomography (CT) of the patient. Results: Of all, 28 of the patients in the study (54%) were male and 24 of them (46%) were female. The average age was 46±12.3 (21-73) years. Among the 52 patients included in the study after ESWL treatment, the stones of the 24 patients (46.2%) were successfully treated. ESWL treatment was unsuccessful in total 28 patients (53.8%). The average size of the stone was 9.8 mm (6-17 mm), the distance between the stone and the skin was 93 mm in average (50-140). The stone density was measured as 845 HU (353-1600). Conclusion: The ESWL treatment is still a noninvasive and successful method for the lower pole kidney stones. While the ESWL success is being determined, the imaging method chosen is important, the use of abdominal CT provides accurate evaluation. The higher success rates of minimal invasive surgery methods is promising and might change the treatment methods in the future. Key words: Kidney stone, lower pole stone, ESWL, success

Anahtar Kelimeler

• Kidney stone, lower pole stone, ESWL, success

Böbrek alt kaliks taşlarının tedavisinde ESWL’nin etkinliği

Öz

Amaç: Üriner sistem taş hastalığının endoürolojik tedavisinde ki gelişmeler birincil seçenek tedavi yöntemleriyle ilgili tartışmalara yol açmıştır. Bu çalışmamızda, böbrek alt pol taşı olan hastalara kliniğimizde uygulanan Ekstrakorporeal Şok dalga litotripsi (ESWL) tedavisinin sonuçları incelenmiştir.Yöntemler: Ocak- Temmuz 2013 tarihleri arasında kontrastsız bilgisayarlı tomografi (BT) sonucuyla teşhis edilip kliniğimizde ESWL uygulanan 271 böbrek taşı hastasının kayıtları retrospektif olarak incelendi. Tedavi öncesi ya da sonrası izlemlerde kontrastsız BT filmleri olmayan ve ESWL tedavisi tamamlanmayan hastalar çalışma dışı bırakılmıştır. 52 hasta, ESWL başarısına göre iki gruba ayrılmıştır. ESWL başarısı, taşın büyüklüğü, taşın yoğunluğu ve taşın cilde olan uzaklığı; kontrastsız BT kayıtlarının incelenmesi ile sağlanmıştır.Bulgular: Çalışmamız, 28 (%54) erkek ve 24 (%46) bayan hastadan oluşmaktadır. Ortalama yaş 46±12,3 (2173) idi. ESWL tedavisi alan ve çalışmaya dahil edilen 52 hastanın 24’ü (%46,2) tedaviden fayda görmüştür, 28’i (%53,8) tedaviden fayda görmemiştir. Ortalama taş boyutu 9.8 mm (6-17 mm), ortalama taş-cilt mesafesi 93 mm idi, ortalama taş yoğunluğu 845 HU idi. Tartışma: ESWL tedavisi böbrek alt pol taşlarında hala non-invaziv ve başarılı bir yöntemdir. ESWL başarısı değerlendirilirken seçilen görüntüleme yöntemi önemlidir ve abdominal BT’nin kullanımı doğru değerlendirme sağlar. Minimal invaziv tedavi yöntemlerinin yüksek başarı oranları umut vericidir ve gelecekteki tedavi yöntemlerinin değişimine neden olabilir

Anahtar Kelimeler

• Böbrek taşı, alt pol taşı, taş kırma

Kaynakça

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