Klinik Araştırma
BibTex RIS Kaynak Göster

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

Yıl 2023, Cilt: 15 Sayı: 3, 109 - 114, 30.09.2023
https://doi.org/10.54233/endouroloji.20231503-1330075

Öz

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.

Etik Beyan

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

Kaynakça

  • 1. Scales CD Jr, Smith AC, Hanley JM, Saigal CS; Urologic Diseases in America Project. Prevalence of kidney stones in the United States. Eur Urol. 2012;62(1):160-165. https://doi.org/10.1016/j.eururo.2012.03.052
  • 2. EAU Guidelines Office, Arnhem, The Netherlands. http://uroweb.org/guidelines/compilations-of-all-guidelines/
  • 3. Lingeman JE, Newman D, Mertz JH, et al. Extracorporeal shock wave lithotripsy: the Methodist Hospital of Indiana experience. J Urol. 1986;135(6):1134-1137. https://doi.org/10.1016/s0022-5347(17)46016-2
  • 4. Brenner DJ, Doll R, Goodhead DT, et al. Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci U S A. 2003;100(24):13761-13766. https://doi.org/10.1073/pnas.2235592100
  • 5. Schindera ST, Nelson RC, Toth TL, et al. Effect of patient size on radiation dose for abdominal MDCT with automatic tube current modulation: phantom study. AJR Am J Roentgenol. 2008;190(2):W100-W105. https://doi.org/10.2214/AJR.07.2891
  • 6. Miller DL, Smith NB, Bailey MR, et al. Overview of therapeutic ultrasound applications and safety considerations. J Ultrasound Med. 2012;31(4):623-634. https://doi.org/10.7863/jum.2012.31.4.623
  • 7. Van Besien J, Uvin P, Hermie I, Tailly T, Merckx L. Ultrasonography Is Not Inferior to Fluoroscopy to Guide Extracorporeal Shock Waves during Treatment of Renal and Upper Ureteric Calculi: A Randomized Prospective Study. Biomed Res Int. 2017;2017:7802672. https://doi.org/10.1155/2017/7802672
  • 8. Abdel-Kader MS, Fathy A, Moubarek M, Abolyosr A. Which is better, fluoroscopic-guided or ultrasonic-guided shock wave lithotripsy for pediatric renal stones? Prospective randomized comparative study. World J Urol. 2023;41(4):1175-1180. https://doi.org/10.1007/s00345-023-04313-2
  • 9. Goren MR, Goren V, Ozer C. Ultrasound-Guided Shockwave Lithotripsy Reduces Radiation Exposure and Has Better Outcomes for Pediatric Cystine Stones. Urol Int. 2017;98(4):429-435. https://doi.org/10.1159/000446220
  • 10. Chang TH, Lin WR, Tsai WK, et al. Comparison of ultrasound-assisted and pure fluoroscopy-guided extracorporeal shockwave lithotripsy for renal stones. BMC Urol. 2020;20(1):183. Published 2020 Nov 10. https://doi.org/10.1186/s12894-020-00756-6
  • 11. Smith HE, Bryant DA, KooNg J, Chapman RA, Lewis G. Extracorporeal shockwave lithotripsy without radiation: Ultrasound localization is as effective as fluoroscopy. Urol Ann. 2016;8(4):454-457. https://doi.org/10.4103/0974-7796.192104
  • 12. Lowe D, Roy L, Tabocchini MA, Rühm W, Wakeford R, Woloschak GE, Laurier D. Radiation dose rate effects: what is new and what is needed?. Radiat Environ Biophys. 2022;61(4):507-543. https://doi.org/10.1007/s00411-022-00996-0
  • 13. Hassanpour N, Panahi F, Naserpour F, Karami V, Fatahi Asl J, Gholami M. A Study on Radiation Dose Received by Patients during Extracorporeal Shock Wave Lithotripsy. Arch Iran Med. 2018;21(12):585-588.
  • 14. Bohris C, Bayer T, Lechner C. Hit/Miss monitoring of ESWL by spectral Doppler ultrasound. Ultrasound Med Biol. 2003;29(5):705-712. https://doi.org/10.1016/s0301-5629(02)00773-1
  • 15. Sun XZ, Zhang ZW. Shock wave lithotripsy for uric acid stones. Asian J Surg. 2006;29(1):36-39. https://doi.org/10.1016/S1015-9584(09)60292-X

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

Yıl 2023, Cilt: 15 Sayı: 3, 109 - 114, 30.09.2023
https://doi.org/10.54233/endouroloji.20231503-1330075

Öz

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.

Kaynakça

  • 1. Scales CD Jr, Smith AC, Hanley JM, Saigal CS; Urologic Diseases in America Project. Prevalence of kidney stones in the United States. Eur Urol. 2012;62(1):160-165. https://doi.org/10.1016/j.eururo.2012.03.052
  • 2. EAU Guidelines Office, Arnhem, The Netherlands. http://uroweb.org/guidelines/compilations-of-all-guidelines/
  • 3. Lingeman JE, Newman D, Mertz JH, et al. Extracorporeal shock wave lithotripsy: the Methodist Hospital of Indiana experience. J Urol. 1986;135(6):1134-1137. https://doi.org/10.1016/s0022-5347(17)46016-2
  • 4. Brenner DJ, Doll R, Goodhead DT, et al. Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci U S A. 2003;100(24):13761-13766. https://doi.org/10.1073/pnas.2235592100
  • 5. Schindera ST, Nelson RC, Toth TL, et al. Effect of patient size on radiation dose for abdominal MDCT with automatic tube current modulation: phantom study. AJR Am J Roentgenol. 2008;190(2):W100-W105. https://doi.org/10.2214/AJR.07.2891
  • 6. Miller DL, Smith NB, Bailey MR, et al. Overview of therapeutic ultrasound applications and safety considerations. J Ultrasound Med. 2012;31(4):623-634. https://doi.org/10.7863/jum.2012.31.4.623
  • 7. Van Besien J, Uvin P, Hermie I, Tailly T, Merckx L. Ultrasonography Is Not Inferior to Fluoroscopy to Guide Extracorporeal Shock Waves during Treatment of Renal and Upper Ureteric Calculi: A Randomized Prospective Study. Biomed Res Int. 2017;2017:7802672. https://doi.org/10.1155/2017/7802672
  • 8. Abdel-Kader MS, Fathy A, Moubarek M, Abolyosr A. Which is better, fluoroscopic-guided or ultrasonic-guided shock wave lithotripsy for pediatric renal stones? Prospective randomized comparative study. World J Urol. 2023;41(4):1175-1180. https://doi.org/10.1007/s00345-023-04313-2
  • 9. Goren MR, Goren V, Ozer C. Ultrasound-Guided Shockwave Lithotripsy Reduces Radiation Exposure and Has Better Outcomes for Pediatric Cystine Stones. Urol Int. 2017;98(4):429-435. https://doi.org/10.1159/000446220
  • 10. Chang TH, Lin WR, Tsai WK, et al. Comparison of ultrasound-assisted and pure fluoroscopy-guided extracorporeal shockwave lithotripsy for renal stones. BMC Urol. 2020;20(1):183. Published 2020 Nov 10. https://doi.org/10.1186/s12894-020-00756-6
  • 11. Smith HE, Bryant DA, KooNg J, Chapman RA, Lewis G. Extracorporeal shockwave lithotripsy without radiation: Ultrasound localization is as effective as fluoroscopy. Urol Ann. 2016;8(4):454-457. https://doi.org/10.4103/0974-7796.192104
  • 12. Lowe D, Roy L, Tabocchini MA, Rühm W, Wakeford R, Woloschak GE, Laurier D. Radiation dose rate effects: what is new and what is needed?. Radiat Environ Biophys. 2022;61(4):507-543. https://doi.org/10.1007/s00411-022-00996-0
  • 13. Hassanpour N, Panahi F, Naserpour F, Karami V, Fatahi Asl J, Gholami M. A Study on Radiation Dose Received by Patients during Extracorporeal Shock Wave Lithotripsy. Arch Iran Med. 2018;21(12):585-588.
  • 14. Bohris C, Bayer T, Lechner C. Hit/Miss monitoring of ESWL by spectral Doppler ultrasound. Ultrasound Med Biol. 2003;29(5):705-712. https://doi.org/10.1016/s0301-5629(02)00773-1
  • 15. Sun XZ, Zhang ZW. Shock wave lithotripsy for uric acid stones. Asian J Surg. 2006;29(1):36-39. https://doi.org/10.1016/S1015-9584(09)60292-X
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Üroloji
Bölüm Araştırma Makaleleri
Yazarlar

Sarp Keskin 0000-0003-4681-5427

Ferhat Keser 0000-0002-2803-6481

Yayımlanma Tarihi 30 Eylül 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 15 Sayı: 3

Kaynak Göster

Vancouver Keskin S, Keser F. Comparison of Extracorporeal Shock Wave Lithotripsy Success Rates Between Ultrasound Targeting and X-ray Targeting. Endourol Bull. 2023;15(3):109-14.