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Extracorporeal shock wave lithotripsy in children and adults: Institute experience using stonelith lithotripter
oleh: M Gopi Kishore, Arif Hameed, Vipul Tandon, Mufti Mohamad, Harbans Singh, Vibhav Malviya, U S Dwivedi, P B Singh
Format: | Article |
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Diterbitkan: | Wolters Kluwer Medknow Publications 2001-01-01 |
Deskripsi
Objectives: To assess the value of extracorporeal shock wave lithotripsy (ESWL) in treating paediatric and adult urolithiasis, and to determine, factors that may affect the results. Patients and Methods: Using Stonelith lithotripter (PCK Electronic Industry and Trade Co. Sincan Org San Orhansik, CAO no. 4, Ankara, Turkey), 92 patients (108 stones) with mean age of 35.1 years (4-72 years) were treated for urinary stones. Of these, 89 stones were renal stones and 19 were ureteric stones. The respective mean stone size was 1.86 curs (0.6-3 cms) for renal stones and 1.61 cms (0.6-2.4 curs) for ureteric stones. The patients were assessed 3 months after treatment and the results compared, to detect factors that might be associated with the stone free rate. Results: Of the 108 stones with 3 months follow-up, the overall stone free rate was 75.9% (82 stones); 14.8% (16 stones) stones showed fragmentation but no clearance of stone fragments (insignificant.fragments of < 5 nun) and 9.25% (10 stones) stones didn′t show any fragmentation at all. For renal stones the overall stone free rate was 74.1% (66 stones); 15.7% (14 stones) showed partial clearance (1 lostfollow-up) and 10.1 % (9 stones) didn′t show any fragmentation. In patients with ureteric stones 16 (84.2%) were stone free after treatment, 2 (10.5%) cases lost follow-up and no, fragmentation in I (5.26%) stone. In cases of children and adolescents 8 stones were completely cleared, 3 stones were partially cleared and there was no fragmentation in 4 stones. The significant factors associated with the stone free rate were size, site, number and radiological abnormalities: there was no significant effect of the type of lithotripter used. Conclusions: ESWL is a safe and effective treatment for both paediatric and adult urolithiasis. The stone free rate is influenced significantly by stone size, site, number and radiological features. Irrespective of the make of lithotripter; the clearance rate was 75 - 97%. JJ stent is not required routinely at the time of ESWL.