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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Rakesh Sharma (SMS Medical College and Hospital) Arpan Choudhary (R G Kar Medical College and Hospital) Ranjit Kumar Das (R G Kar Medical College and Hospital) Supriya Basu (R G Kar Medical College and Hospital) Ranjan Kumar Dey (R G Kar Medical College and Hospital) Rupesh Gupta (R G Kar Medical College and Hospital) Partha Pratim Deb (R G Kar Medical College and Hospital)
저널정보
대한비뇨기과학회 Investigative and Clinical Urology Investigative and Clinical Urology Vol.58 No.2
발행연도
2017.1
수록면
103 - 108 (6page)

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Purpose: Extracorporeal shock wave lithotripsy (ESWL) is an established modality for renal calculi. Its role for large stones is being questioned. A novel model of temporary double J (DJ) stenting followed by ESWL was devised and outcomes were assessed. Materials and Methods: The study included 95 patients with renal calculi sized 1 to 2 cm. Patients were randomized into 3 groups. Group 1 received ESWL only, whereas group 2 underwent stenting followed by ESWL. In group 3, a distinct model was applied in which the stent was kept for 1 week and then removed, followed by ESWL. Procedural details, analgesic requirements, and outcome were analyzed. Results: Eighty-eight patients (male, 47; female, 41) were available for analysis. The patients' mean age was 37.9±10.9 years. Stone profile was similar among groups. Group 3 received fewer shocks (mean, 3,155) than did group 1 (mean, 3,859; p=0.05) or group 2 (mean, 3,872; p=0.04). The fragmentation rate was similar in group 3 (96.7%) and groups 1 (81.5%, p=0.12) and 2 (87.1%, p=0.16). Overall clearance in group 3 was significantly improved (83.3%) compared with that in groups 1 (63.0%, p=0.02) and 2 (64.5%, p=0.02) and was maintained even in lower pole stones. The percentage successful outcome in groups 1, 2, and 3 was 66.7%, 64.5%, and 83.3%, respectively (p=0.21). The analgesic requirement in group 2 was higher than in the other groups (p=0.00). Group 2 patients also had more grade IIIa (2/3) and IIIB (1/2) complications. Conclusions: Stenting adversely affects stone clearance and also makes the later course uncomfortable. Our model of brief stenting followed by ESWL provided better clearance, comfort, and a modest improvement in outcome with fewer sittings and steinstrasse in selected patients with large renal calculi.

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참고문헌 (18)

참고문헌 신청
Norlin A / 1976 / A study of its frequency / Scand J Urol Nephrol 10:150~153 google schola Lechevallier E / 2008 / Management of renal stones / Prog Urol 18:959~962 google schola Shen P / 2011 / Use of ureteral stent in extracorporeal shock wave lithotripsy for upper urinary calculi: a systematic review and meta-analysis / J Urol 186:1328~1335 google schola Ghoneim IA / 2010 / Extracorporeal shock wavelithotripsy in impacted upper ureteral stones: a prospective randomized comparison between stented and non-stented techniques / Urology 75:45~50 google schola Sfoungaristos S / 2012 / Stenting or not prior to extracorporeal shockwave lithotripsy for ureteral stones? Results of a prospective randomized study / Int Urol Nephrol 44:731~737 google schola

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