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1.
We reviewed 50 patients with staghorn stones to determine whether extracorporeal shock wave lithotripsy monotherapy is a successful alternative to the classical approaches (open operation versus percutaneous lithotripsy alone or with extracorporeal shock wave lithotripsy). Results free of stones at long-term followup (greater than 3 months) were obtained in 28 of 50 patients (56%) and when we included residual fragments with a diameter of less than 4 mm. (9 patients, or 18%) an over-all success rate of 74% (37 patients) was achieved. Of the patients 41 had a Double-J stent to improve fragment evacuation (5 experienced obstructive elimination), while uncomplicated evacuation was noted in the remaining 9 without a stent. No case of septicemia after extracorporeal shock wave lithotripsy was observed but all patients had received strict antimicrobial prophylaxis. 相似文献
2.
A. Kostakopoulos N. J. Stavropoulos C. Makrichoritis D. Picramenos Ch. Deliveliotis 《International urology and nephrology》1996,28(2):157-161
This report presents our initial experience in 36 patients with bladder stones, treated by extracorporeal shock wave lithotripsy.
Minute fragmentation and uncomplicated evacuation occurred in 26 patients (72%). Mean treatment duration was 55 minutes. Mean
number of shock waves was 3600 and electrical discharge averaged 24 kV per shock wave. No morbidity, during or after treatment,
was encountered in these patients. The treatment was performed without the use of anaesthesia on an outpatient basis. 相似文献
3.
Extracorporeal shock wave lithotripsy monotherapy: experience with piezoelectric second generation lithotriptor in 642 patients 总被引:1,自引:0,他引:1
Extracorporeal shock wave lithotripsy monotherapy was performed in 642 patients for 1 year with an EDAP-LT01 piezoelectric lithotriptor. Of 642 patients 398 completed extracorporeal shock wave lithotripsy treatment and 244 still are undergoing multiple extracorporeal shock wave lithotripsy sessions. The 398 patients had renal (64.6 per cent) or ureteral (35.4 per cent) stones 0.6 to 4.8 cm. in diameter (mean 1.4 cm.). No general or regional anesthesia was required except in 7 children. Among 398 patients who completed extracorporeal shock wave lithotripsy the rate free of stones was 73.4 per cent and the rate of clinically insignificant residual fragments was 12.8 per cent. The success rate (rate free of calculi plus that of clinically insignificant renal fragments) ranged from 95.6 per cent for stones 0.6 to 1.0 cm. in diameter to 52.6 per cent for stones larger than 3.0 cm. (mean 86.2 per cent). The number of treatment sessions in 343 patients with successful results increased in accordance with the stone size, with an average of 1.6 sessions. Double-J* stents were placed in 7 patients and ureteral catheterization was performed in 11 as post-extracorporeal shock wave lithotripsy adjunctive measures. The steinstrasse phenomenon was noted in 14 patients, of whom only 1 required Double-J stenting. There were no significant complications. Therefore, extracorporeal shock wave lithotripsy monotherapy with the piezoelectric lithotriptor is considered to be a safe and efficient outpatient procedure for the initial treatment of urinary stones regardless of stone sizes. 相似文献
4.
Extracorporeal shock wave lithotripsy treatment in paraplegic patients with bladder stones 总被引:1,自引:0,他引:1
Mete Kilciler Fahri Sümer Selahattin Bedir Yaar Özgök Doan Erduran 《International journal of urology》2002,9(11):632-634
BACKGROUND: Spinal cord injury patients are at increased risk of developing urolithiasis and many will require treatment, most commonly with extracorporeal shock wave lithotripsy (ESWL). METHODS: We examined 20 consecutive spinal cord injury patients (all male) undergoing ESWL for the treatment of bladder stones between April 1992 and May 2000. The mean number of shock waves administered in these 20 patients was 3600 and the shock power was 19 kW/s. All patients were treated without anesthesia. After ESWL, the bladder was irrigated with povidone iodine solution and stone fragments were evacuated through a 22F endoscopic sheath. RESULTS: All patients became stone-free after ESWL. Stone fragments were observed in the urethra of 3 patients, which were removed by urethroscopy. No major complication was observed; however, 5 patients had minor hematuria (which subsided within 24 h) and subfebrile fever (37.2-37.5 degrees C). CONCLUSION: ESWL and transurethral bladder irrigation is a safe, effective and simple modality for the treatment of bladder stones in spinal cord injury patients. 相似文献
5.
Extracorporeal shock wave lithotripsy is a noninvasive technique for treatment of patients with gallbladder and bile duct stones. Selected patients with gallbladder stones can be treated on an outpatient basis without general anesthesia and may return to full activity within 1 or 2 days. Stone-free rates of 40% to 60% at 6 months have been achieved in most reported series with minimal morbidity. Bile duct stone lithotripsy has achieved stone clearance in 80% of patients in whom conventional methods were unsuccessful and therefore constitutes a valuable second-line treatment for these patients. 相似文献
6.
7.
Isa WA Robles JE Aguera LG Zudaire JJ Sanchez PL Berian JM 《The Journal of stone disease》1992,4(3):249-252
Extracorporeal shock wave lithotripsy (ESWL) has proven to be effective for the treatment of renal calculi. However, its use for ureteral stones as monotherapy is controversial. In this study, 142 patients underwent in situ ESWL for ureteral stones. Stone fragmentation was achieved in 87.4% of the patients. Stone clearance rate at 3 months was 95.8%, 94.7%, and 94.2% for stones located in upper, middle, and lower ureter, respectively. Efficiency quotient calculated for the overall stone clearance at 15 days, 1 month, and 3 months was 74.6, 71.8, and 71.7, respectively. Treatment was performed in 82.5% of patients as an outpatient procedure. Our data show that in situ monotherapy is an effective and noninvasive method for treating ureteral stones. 相似文献
8.
One hundred forty-seven cases of staghorn calculi were treated with HM-3 Dornier lithotripter. The stone located at the right tract in 71, the left 65 and 11 bilaterally. Fifteen cases had stones larger than 6 cm in length, the biggest size was 11 cm in diameter. Majority of the patients in this group underwent multiple ESWL treatment. PCN was needed in only 4 cases. For safety reason, The interval between two ESWL treatment should be more than 1 week. All stones were completely fragmented and discharged no longer than 4 months. The overall procedural complications were relatively low and not severe. Hematuria occurred in all the patients, fever in 8.8% and pain in 12.2%. The results of this study indicate that the majority of staghorn stone could be treated satisfactory with ESWL. 相似文献
9.
K Yamamoto Y Katoh N Kumata T Kishimoto S Wada W Sakamoto T Sugimoto Y Ameno S Ohyama M Kamizuru 《Hinyokika kiyo. Acta urologica Japonica》1991,37(10):1121-1124
We report our experience with extracorporeal shock wave lithotripsy (ESWL) in the treatment of ureteral and cystine stones, which are known to be difficult to treat by this method. First, in order to determine the effectiveness of the ureteral catheter in the destruction of ureteral stones, we compared the clinical results of 121 patients treated without the catheter and 141 patients inserted with the catheter. There was no significant difference in the success rate between the two groups regardless of stone size, which indicates that the use of the ureteral catheter had no effect on the outcome of treatment. We then studied the clinical results of impacted ureteral stones which are especially difficult to destroy. Excretory urography was performed to non-invasively diagnose these stones, and those without visualization in the ureter below the stone were diagnosed as impacted stones and treated by ESWL without the ureteral catheter. Among the stones with a diameter of 1 to 2 cm, the success rate was significantly lower in impacted stones compared to non-impacted stone. These findings suggest that ESWL treatment without the ureteral catheter may be effective for ureteral stones with a diameter of less than 1 cm and non-impacted stones with a diameter of 1 to 2 cm, while combination therapy with other methods such as TUL may be better for other stones. We also performed ESWL on 6 patients with renal stones and 2 patients with ureteral stones which were cystine stones. Renal stones required an average 4.1 treatment with an average of 1,875 shocks per treatment, and ureteral stones required 1.5 treatment with an average of 1,833 shocks.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
10.
H Ushida M Maegawa S Maekawa K Inoue Y Kaneko K Ohmori K Nishimura 《Hinyokika kiyo. Acta urologica Japonica》2001,47(10):709-713
Between August 1999 and July 2000, 123 cases of renal stones and 52 cases of ureteral stones in 116 males and 59 females were treated with the New Piezolith 2500. The average number of sessions required for renal and ureteral stones was 2.50 and 1.48, respectively. At 3 months postoperatively, stone-free rates for renal and ureteral stones were 64.2% and 72.7%, respectively. Assessing residual stones less than 4 mm in diameter as an effective treatment outcome, the efficacy rates for renal and ureteral stones were 94.3% and 86.4%, respectively. Side effects were encountered in 5 cases (2.9%) of high fever and one case (0.57%) of renal subcapsular hematoma. New Piezolith 2500 is effective and safe for the treatment of upper urinary stones. 相似文献
11.
T. Patrashkov P. Michailov A. Lilov S. Nikolov C. Damianov 《International urology and nephrology》1988,20(6):577-583
In the present paper we report on one-year experience with the application of extracorporeal shock wave lithotripsy (ESWL)
in 157 patients with stones in the ureter 63 of which were in the pyeloureteral segment, 52 in the lumbar part and 42 in the
distal third. The indications and contraindications for lithotripsy, the peculiarities in performing the manipulation are
determined and the results analysed. They are evaluated as very good because 78.98% of the patients have passed completely
disintegrated stones up to the tenth day after lithotripsy. The average hospital stay was 4.08 days. The drawback of the method
is the high cost of manipulation. 相似文献
12.
13.
Three hundred and sixteen patients with ureteral stones were treated in situ (without retrograde stone manipulation) with and without stent bypass (DJ stent, ureteral catheter). Results were generally better with stent bypass, but only marginally so for stones larger than 10 mm in diameter. Regardless of whether or not the ureter was stented, lower ureteral stones were more difficult to fragment than upper ureteral stones and pre-sacral stones did not respond well to in situ treatment. We observed that evaluation of stone disintegration and fragment evacuation could only be properly assessed after approximately 3 weeks post-ESWL. 相似文献
14.
The purpose of endoscopic therapy in chronic pancreatitis is to decompress the main pancreatic duct and to remove the obstacles
that impede the ductal flow of pancreatic juice. The availability of extracorporeal shock wave lithotripsy (ESWL) has improved
the results of endoscopic drainage of the main pancreatic duct and has also expanded the indications of endoscopic therapy
for chronic pancreatitis. This article briefly reviews ESWL for pancreatic duct stones in patients with chronic pancreatitis,
including our experience with ESWL. ESWL is an effective and safe procedure for endoscopically unremovable main pancreatic
duct stones, and, in selected patients, ESWL alone may be effective. 相似文献
15.
Extracorporeal shock wave lithotripsy was used to treat multiple, large, bulbous urethral calculi in a paraplegic man. Prior attempt at endoscopic extraction was unsuccessful owing to the size and location of the calculi. Two treatments of 3,000 shocks each resulted in fragmentation of the calculi 相似文献
16.
We treated successfully 16 patients with stones in the mid ureter, that is overlying the pelvic bone, in the prone position with a Dornier HM3 lithotriptor. The lithotriptor was equipped with the original reflector and generator system, and all treatments were performed with only surface anesthesia of the skin and premedication with pethidine chloride and diazepam. Between 1 and 3 sessions were necessary with up to 2,000 shock waves at each session. The generator voltage was varied between 14 and 18 kv. After completion of extracorporeal shock wave lithotripsy all patients became free of stones without ureteroscopy or transureteral manipulation except for a ureteral catheter and fluid irrigation during treatment. 相似文献
17.
From Sep. 1988 to Dec. 1989, 163 patients with gallstones and 7 with choledocholith were treated by biliary extracorporeal shock wave lithotripsy (ESWL). After lithotripsy, ursodeoxycholic acid was administered in 74 patients, and self-made lithoexpulsive in 44 patients. The remaining 52 patients were given both ursodeoxycholic acid and lithoexpulsive. The total rate of stone fragmentation was 97.6%. One hundred and twenty patients were followed up after ESWL. Biliary stones disappeared in 26.6% of the patients within one month after ESWL, in 33.3% within one to three months, and in 36.6% within six to eight months. There were no severe complications. 10.1 percent of the patients had abdominal discomfort during the procedure of ESWL, and cutaneous petechiae were found in 12.2% of the patients. Other complications included biliary colic in 6, jaundice in 2, and hematuria in 2. Serum enzymology and chest X-ray remained unchanged after ESWL. 相似文献
18.
P Rigatti F Montorsi G Guazzoni M Maffezzini 《Scandinavian journal of urology and nephrology》1989,23(1):67-69
Extracorporeal shock wave lithotripsy represents the first choice therapy for reno-ureteral stone disease, being successful in more than 85% of cases. When extracorporeal shock wave lithotripsy is associated with both appropriate cystoscopic manipulations and with a proper positioning of the patient on the stretcher of the lithotripter, it can be successfully applied to ureteral stones regardless of their specific location. We report 99 patients with ureteral calculi submitted to extracorporeal shock wave lithotripsy with a stone free rate of 98%. 相似文献
19.
Y Ono M Sahashi J Watanabe S Yamada O Kamihira S Hirabayashi Y Nakano K Miyake S Ohshima 《Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology》1991,82(3):433-438
From October, 1987 to September, 1989, 53 staghorn calculi of 51 patients underwent extracorporeal shock wave lithotripsy (ESWL) monotherapy by using Dornier HM3 lithotriptor. All patients were treated with double J stenting preoperatively. Mean number of shock waves was 6092 and mean number of sessions was 2.1. In 52 out of 53 kidneys (98%), the stones were disintegrated completely. Complete removal of the stone were observed in 29 kidneys (55%) 3 months after the last ESWL treatment. Complications consisted of fever attack (more than 38 degrees C) (26 patients), ileus (2), subcapsular hematoma (2) and gastrointestinal hemorrhage (1). They could be conservatively treated except one case with percutaneous nephrostomy. Supplementary procedures for the stone street were necessary in 23 patients. They consisted of ESWL (16 patients) and transuretheral lithotripsy (7). The indication of this procedure for the treatment of staghorn calculi was also discussed. 相似文献
20.
Stones situated anteriorly cannot be satisfactorily reached with extracorporeal shock wave lithotripsy (ESWL) in the supine position. By assuming the prone position, patients with stones in horseshoe or ectopic kidneys or in the iliac ureter can be treated by ESWL with the same success rate as patients with posterior stones. This new technique has been used in 30 patients with iliac ureteral stones, 5 patients with caliceal stones in horseshoe kidneys and 1 patient with a pyelic stone in a sacral kidney. 相似文献