Extremely-slow, half-number shockwave lithotripsy for asymptomatic renal stones <20 mm

Katsuhiro Ito; Toshifumi Takahashi; Toru Kanno; Takashi Okada; Yoshihito Higashi; Hitoshi Yamada

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자료유형: 학술저널

저자정보: Katsuhiro Ito (Ijinkai Takeda General Hospital) Toshifumi Takahashi (Ijinkai Takeda General Hospital) Toru Kanno (Ijinkai Takeda General Hospital) Takashi Okada (Ijinkai Takeda General Hospital) Yoshihito Higashi (Ijinkai Takeda General Hospital) Hitoshi Yamada (Ijinkai Takeda General Hospital)

저널정보: 대한비뇨기과학회 Investigative and Clinical Urology Investigative and Clinical Urology Vol.62 No.1

발행연도: 2021.1

수록면: 72 - 78 (7page)

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Purpose: To compare the treatment success rate and safety of reduced (30 shocks/min, 1,200 shocks/session) versus standard (60 shocks/min, 2,400 shocks/session) extracorporeal shockwave lithotripsy for the management of renal stones. Materials and Methods: We retrospectively analyzed 404 patients who underwent extracorporeal shockwave lithotripsy for 5–20-mm renal stones between April 2011 and March 2019. Patients selected the reduced or standard protocol (group R and S) after explaining the potential benefits and disadvantages. The primary outcome was treatment success within 12 weeks, which was defined as no residual fragment or fragments <4 mm on ultrasonography and plain radiograph. Results: In total, 94 and 310 patients underwent shockwave lithotripsy with a reduced and standard protocol, respectively. The background characteristics of the participants did not significantly differ. The treatment success within 12 weeks was achieved in 78 (83.0%) patients in group R and 259 (83.5%) in group S (p=0.88). The median number of the session was 3 (interquartile range, 2–4) in both groups (p=0.53). The total complication rates were 5.4% in group R and 6.1% in group S. Three (1.0%) patients in group S experienced perirenal hematoma, which was conservatively treated. The reduced protocol was not associated with treatment success in the multivariate analysis adjusted for potential confounders (odds ratio, 0.91; 95% confidence interval, 0.46–1.80; p=0.78). Conclusions: The new treatment amendment with a slower delivery rate successfully reduced the total number of shocks need to fragment renal stones <20 mm without compromising the stone-free rate.

#Extracorporeal shockwave therapy #Kidney calculi #Lithotripsy #Nephrolithiasis #Urolithiasis

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Katsuhiro Ito

소속기관 Tenri Hospital

주요연구분야 의약학 > 임상의학 > 비뇨기과학

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Toshifumi Takahashi