Comparative Results of Shockwave Lithotripsy for Renal Calculi in Upper, Middle, and Lower Calices

Turna, Burak; Ekren, Fatih; Nazlı, Oktay; Akbay, Kaan; Altay, Barış; Ozyurt, Ceyhun; Cikili, Necmettin

doi:10.1089/end.2006.0275

Cited by 25 publications

(13 citation statements)

References 18 publications

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“…12 Present study also matches with the study of Turna B, et al in terms of the stone-free rates for stones in the upper, middle, and lower calices. 13 It also matches with study of Sumino Y et al, who reported an overall stone clearance rate of 54% for lower pole calyceal stones and with the study of Pacik D et al who's success rate of lower pole calculi is 61.3%. 14,15 ESWL success for lower pole calculi is slightly lower than the results of the study of Gupta et al who achieved an overall stone clearance at 6 months of about 72% for lower calyceal stones.…”

Section: Discussionsupporting

confidence: 89%

“…The final outcome of the present study matches with the study of Turna B, et al in which success of ESWL for calculi <10 mm and between 11-20 mm was 91.2% and 65.5% respectively (p = 0.001). 13 AbdelKhalek M et al found that size was significant independent predictor of ESWL outcome (p < 0.001). 8 In the study of Wang L et al 16 ESWL outcome was not significant for the calculi >12 mm, which is in contradiction to the present results in which outcome for calculi between 11-20 mm was significant at 84.2%.…”

Section: Discussionmentioning

confidence: 98%

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Study of factors predicting clinical outcomes of extracorporeal shock wave lithotripsy in Indian patients with upper urinary tract calculi

Panchal

Krishnaswamy

Dabhade³

et al. 2018

Int Surg J

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Background: Extracorporeal shock wave lithotripsy (ESWL) is an effective non-invasive method for managing urinary tract calculi. Present study was undertaken to evaluate factors that may influence ESWL clinical outcomes in Indian patients with urinary tract calculi.Methods: This prospective study was conducted at Department of Urology, Medical Trust Hospital Cochin, India in the period from September 2006 to March 2009. Sixty patients with upper urinary tract lithiasis having stone size between 5 to 25 mm were included and patients with ˃2 calculi, distal ureteric obstruction (not relieved), renal anomalies were excluded. All patients were treated with DIREX medical system lithotripter. Clinical outcome of ESWL was assessed by factors like site, size, density and skin-to-stone distance. After statistical analysis, p-value ≤0.05 was taken as the level of significance.Results: The overall success of ESWL was 82%. The final success of ESWL for sites like ureter, pelvis, mid or upper and lower calyx were 94.1%, 84%, 85.7% and 58% respectively (p = 0.095). The rate of fragmentation of stone after one session of ESWL for stone size ≤10 mm, 11 mm - 20 mm and ≥21 mm was 76.5%, 68.4% and 16.7% respectively (p=0.009). For stone density 751-1000 HU, 22.2% patients required ≥2 sessions to achieve stone free status (p<0.0005). Around 15.6% patients in skin-to-stone distance (SSD) ≤10cm required ≥2 sessions to achieve stone free status (p = 0.27).Conclusions: ESWL should be considered a primary modality of treatment in patients with calculi size ≤20 mm, density ≤ 1000 HU, pelvic, ureteric and upper and/or middle calyceal calculi and for SSD ≤10 cm.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 98%

Study of factors predicting clinical outcomes of extracorporeal shock wave lithotripsy in Indian patients with upper urinary tract calculi

Panchal

Krishnaswamy

Dabhade³

et al. 2018

Int Surg J

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“…Nowadays, these stones can be treated with retrograde intrarenal surgery (RIRS), ESWL, and percutaneous nephrolithotomy. [9,10] ESWL, and RIRS can be successfully performed for stones smaller than 2 cm in diameter, and increased stone size decreases success rates of both treatment modalities. [11] Besides, narrow, and elongated neck of the calyx containing the stone prevents spontaneous passage of fragmented stone particles.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location?

Özgör

Küçüktopçu

Şimşek

et al. 2015

Turkish Journal of Urology

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Objective: To evaluate the effect of percutaneous access site on the success and complication rates of isolated calyceal stones. Material and methods:We retrospectively evaluated 2700 patients who underwent percutaneous nephrolithotomy (PNL) in our clinic between October 2002 and August 2014. We selected only the patients with isolated lower, middle or upper calyceal stones and we grouped the patients according to the location of their stones. Successful operation was defined as complete stone clearence or retention of stone fragments smaller than 4 mm which do not lead to infection, obstruction or pain requiring treatment. Intraoperative and postoperative complications were also recorded.Results: Totally 360 patients underwent PNL for their isolated upper, middle and lower calyceal stones. Access sites for those patients were selected based on stone location. The stones were localized in the lower (n=304), middle (n=14), and upper (n=42) calices. There was no statistically significant difference between the groups with respect to operation and scopy times. Hemoglobin drop was seen more frequently in the upper calyceal access group, without any significant intergroup difference. Thoracic complications including hemothorax, pneumothorax and pleural effusion were more common in the upper calyceal access group (11.9%; p<0.001). Complete stone clerance was accomplished in 81.9%, 92.9% and 78.6% of the patients with lower, middle and upper calyceal stones respectively without any significant intergroup difference (p=0.537). Conclusion:PNL is an effective and safe treatment modality for isolated calyceal kidney stones and upper calyceal access causes thoracic complications more than other access sites.

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“…[4] However, SWL seems to be affected by stone location, with documented stone free rates of 82.8%, 83.4% and 67.5% for upper, middle and lower calices, respectively. [5] Improvements in endoscope design, optical quality and laser devices have made fURS an effective option for the treatment of kidney stones. The high stone-free rates combined with low rate of complications have resulted in the widespread usage of fURS.…”

Section: Introductionmentioning

confidence: 99%

Previous shock-wave lithotripsy treatment does not impact the outcomes of flexible ureterorenoscopy

Yürük¹,

Binbay²,

Akman³

et al. 2014

Turkish Journal of Urology

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Objective: Shock-wave lithotripsy (SWL) is the first-line treatment for the active removal of small and medium-sized kidney stones. Flexible ureterorenoscopy (fURS) is recommended after failed SWL treatment. The aim of this retrospective analysis is to evaluate whether prior unsuccessful SWL treatments affect the outcomes of fURS. Material and methods:Data from 206 patients who underwent fURS for the treatment of renal stones between September 2009 and January 2011 were collected, and the patients were divided into two groups according to their previous SWL treatment. The patient demographics, stone characteristics, operation and fluoroscopy times, stone-free rates and complications were compared.Results: Of the patients, 114 (55.3%) did not undergo SWL prior to fURS (Group 1), whereas 92 (44.6%) completed a minimum of 3 sessions of SWL and waited at least 2 weeks before the fURS operation (Group 2). Although the mean stone number was higher in Group 2, this difference was not significant (p= 0.06). The mean operation (p= 0.12) and fluoroscopy times (p= 0.69) were similar between the groups. The mean operation time per mm 2 stone and fluoroscopy time per mm2 stone were not significantly different (p= 0.64 and p= 0.76, respectively). The length of the hospitalization and the overall complication rates were similar. After the third postoperative month, the stone-free rates were not different between the groups (82.5% and 86.9%, respectively, p=0.38). Conclusion:The stone-free and complication rates of fURS were not affected by previous SWL therapy.

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Comparative Results of Shockwave Lithotripsy for Renal Calculi in Upper, Middle, and Lower Calices

Abstract: We recommend SWL as the first choice for treatment of stones <200 mm2 in the upper and middle calices. Extracorporeal lithotripsy is one of the options for lower-caliceal stones <200 mm2 but has high re-treatment and auxiliary-procedure rates in these cases.

Cited by 25 publications

References 18 publications

Study of factors predicting clinical outcomes of extracorporeal shock wave lithotripsy in Indian patients with upper urinary tract calculi

Study of factors predicting clinical outcomes of extracorporeal shock wave lithotripsy in Indian patients with upper urinary tract calculi

Percutaneous nephrolithotomy for isolated calyceal stones: How important is the stone location?

Previous shock-wave lithotripsy treatment does not impact the outcomes of flexible ureterorenoscopy

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