Dergiler / Turkish Journal of Urology / 2018 / Cilt: 44 - Sayı: 3

Comparison of ureteroscopic pneumatic lithotripsy and extracorporeal shock wave lithotripsy for the management of proximal ureteral stones: A single center experience

Proksimal üreter taşlarının tedavisinde üreteroskopik pnömatik ve bedendışı şok dalgalarıyla taş kırmanın karşılaştırması: Tek merkez deneyimi

Sayfa
221–227
DOI
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Treatment costs were significantly lower for the ESWL group

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Amaç & Hipotez:Objective: To evaluate and compare the effectiveness of ureteroscopic (URS) pneumatic lithotripsy versusextracorporeal shock wave lithotripsy (ESWL) in the management of the proximal ureteral stones in termsof stone- free rates, complications and costs involved.Material and methods: We included 200 patients in Group 1 who underwent ESWL and 200 patients inGroup 2 who underwent URS intervention.
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Temel Bulgular & Veri:We used Modulith SL X lithotripter 3rd generation Storz medicalfor ESWL group while Swiss pneumatic lithoclast was used to break the stone in the URS group.
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Sonuç & Katkı:Treatment costs were significantly lower for the ESWL group
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

Objective: To evaluate and compare the effectiveness of ureteroscopic (URS) pneumatic lithotripsy versusextracorporeal shock wave lithotripsy (ESWL) in the management of the proximal ureteral stones in termsof stone- free rates, complications and costs involved.Material and methods: We included 200 patients in Group 1 who underwent ESWL and 200 patients inGroup 2 who underwent URS intervention. We used Modulith SL X lithotripter 3rd generation Storz medicalfor ESWL group while Swiss pneumatic lithoclast was used to break the stone in the URS group. Stone-freestatus was defined as stone fragment of less than 4 mm on follow- up kidney ureter and bladder X-ray after3 months of procedure. SPSS version 16 was used for statistical analysis.Results: The mean age in ESWL and URS groups were 39.21±13.36, and 43.13±13.65 years respectively.Mean stone size was 10.47±3.7 mm (ESWL) and 13.6±6.6 mm (URS). Stone- free rate after single procedurewas (125/200 patients) 62.5% for ESWL and (168/200 patients) 84% for URS group (p=0.001). Complicationsincluded post procedure sepsis in 3 (1.5%) patient of ESWL, while 7 (3.5%) patients of URS groups.Steinstrasse was seen in 4 (2%) patients of ESWL group. No mortality was seen in both groups. Mean costsfor ESWL were US $320±50 while US $1100±150 for URS group (p=0.001).Conclusion: The stone-free rates after single procedure were significantly higher for the URS group while thecomplication rates were comparable in both groups. Treatment costs were significantly lower for the ESWL group

Abstract

Amaç: Taşsızlık oranları, komplikasyonlar ve maliyetler açısından üreteroskopik pnömatik ve bedendışı şok dalgalarıyla taş kırmanın etkililiğinin değerlendirilmesi ve karşılaştırılması. Gereç ve yöntemler: Bedendışı şok dalgalarıyla taş kırma (ESWL) (Grup 1) ve üreteroskopik girişim grubunun (URS) (Grup 2) her birine 200 hasta dahil edilmiştir. Taş kırmak için Grup 1’de Modulith SL X 3. kuşak Storz litotriptörünü, URS grubunda (Grup2) Swiss pnömatik litoklastı kullanılmıştır. Taşsızlık oranı izlem sırasında, işlemden 3 ay sonra çekilen direkt üriner grafide 4 mm’den küçük taş parçacığının kalması olarak tanımlandı. İstatistiksel analiz için SPSS’nin 16. sürümü kullanıldı. Bulgular: Yaş ortalaması ESWL ve URS gruplarında sırasıyla 39,21±13,36 ve 43,13±13,65 yıl idi. Ortalama taş çapları ESWL ve URS gruplarında sırasıyla 10,47±3,7 mm ve 13,6±6,6 mm idi. Tek bir işlemden sonra taşsızlık oranları ESWL ve URS gruplarında sırasıyla (125/200) %62,5 ve (168/200) %84 idi (p=0,001). Komplikasyonlardan işlem sonrası sepsis ESWL ve URS gruplarında sırasıyla 3 (%1,5) ve 7 (%3,5) hastada görülmüştür. Taş yolu ESWL grubunda 4 (%2) hastada görülmüştür. Her iki grupta ölüm görülmemiştir. ESWL ve URS gruplarında ortalama maliyetler sırasıyla 320±50 ve 1100±150 ABD dolarıydı (p=0,001). Sonuç: Tek bir i şlemden sonra t aşsızlık o ranları U RS g rubunda a nlamlı d erecede d aha y üksek, k omplikasyon oranları ise her iki grupta benzer oranlardaydı. Tedavi maliyetleri ESWL grubunda anlamlı derecede daha düşük idi.

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Bu Makaleye Atıf Yap

IQBAL, N., MALİK, Y., NADEEM, U., KHALİD, M., PİRZADA, A., MAJEED, M., MALİK, H. A., AKHTER, S. (2018). Comparison of ureteroscopic pneumatic lithotripsy and extracorporeal shock wave lithotripsy for the management of proximal ureteral stones: A single center experience. Turkish Journal of Urology, Cilt: 44 - Sayı: 3, 221–227. https://ajindex.com/articles/380016

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Kaynakça (2)

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