Extracorporeal shock-wave lithotripsy (ESWL) for treatment of urolithiasis

Chaussy, C.; Schmiedt, E; Jocham, Dieter; Schüller, J.; Brandl, Herbert; Liedl, B.

doi:10.1016/0090-4295(84)90243-7

Cited by 304 publications

(112 citation statements)

References 7 publications

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“…During the last years the number of shock waves applied for kidney stone destruction has increased considerably. The first 945 patients were treated with an average of 978 shock waves (Chaussy et al 1984) and this number has increased to an average of about 1300 shock waves (Chaussy et al 1986c;Schmidt and Eisenberger 1987). Shock waves caused haemorrhages in kidneys, but this effect, however, is considered as a minor injury and even 3000 shock waves are considered as tolerable (Delius et al 1988).…”

Section: Discussionmentioning

confidence: 99%

Effect of shock waves on suspended and immobilized L1210 cells

Brümmer

Brenner

Bräuner

et al. 1989

Ultrasound in Medicine & Biology

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Abstract--Ll210 mouse leukemia cells have been exposed to different doses of shock waves generated by underwater spark discharge at 18 kV in an experimental lithotripter (XL1, Dornier). Histological and flow cytometric investigations revealed severe damage and a LDso of about 420 shock waves when the cells were treated as suspensions. Cells immobilized in gelatine, however, were unaffected, indicating that secondary effects are responsible for the cellular damage. Possible mechanisms such as cavitation, jets, and shear forces are discussed.

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Section: Discussionmentioning

confidence: 99%

Effect of shock waves on suspended and immobilized L1210 cells

Brümmer

Brenner

Bräuner

et al. 1989

Ultrasound in Medicine & Biology

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“…Despite these benefits, the use of ungated lithotripsy increases the risk of developing CD. [17][18][19][20][21] The impact of different ungated fixed rates is unknown.…”

Section: Discussionmentioning

confidence: 99%

Variables influencing the likelihood of cardiac dysrhythmias during extracorporeal shock wave lithotripsy

Skinner¹,

Norman²

2012

cuaj

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Introduction: Extracorporeal shock wave lithotripsy (ESWL) is a safe and effective treatment of upper urinary tract calculi. While serious side effects are rare, transient cardiac dysrhythmias (CD) may be associated with ESWL. The exact etiology of these events, which are often unpredictable, is poorly understood. Awareness of CD during ESWL and identification of risk factors for developing them could help clinicians predict and manage them safely and effectively. The current study examines selected variables to determine whether they may predispose individuals to developing CD during ESWL. Methods: We compared 16 patients who experienced CD during ESWL to 56 control patients. Cases and controls were compared with respect to several continuous and discrete variables, including age, pre-treatment heart rate, number of shocks received during treatment, energy setting of the lithotripter, gender, presence of a ureteric stent, previous ESWL and side being treated. Results: Cardiac dysrhythmias occurred more frequently in younger patients and in those being treated for right-sided stones. The other variables did not influence the likelihood of CD. All CD resolved promptly following conversion to electrocardiogram (ECG)-gating. Conclusion: Younger age and right-sided treatment predisposed individuals to developing CD during ESWL. Careful ECG monitoring should be performed during treatment. RésuméIntroduction : La lithotripsie extra-corporelle par ondes de choc (LECOC) est un traitement sûr et efficace pour les calculs des voies urinaires supérieures. Les effets secondaires graves sont rares, mais des dysrythmies cardiaques (DC) transitoires peuvent être associées à la LECOC. L'étiologie précise de ces manifestations souvent imprévisibles est mal établie. La reconnaissance d'une DC pendant la LECOC et des facteurs de risque de cette manifestation pourrait aider les cliniciens à en prédire la survenue et à traiter cette manifestation avec efficacité et en toute sécurité. L'étude présentée ici examine des variables sélectionnées pour déterminer si ces dernières peuvent prédisposer à la survenue d'une DC pendant une LECOC. Méthodologie : Nous avons comparé 16 patients ayant présenté une DC pendant une LECOC et 56 patients témoins. Les cas de DC et les témoins ont été comparés sur le plan de plusieurs variables continues et ponctuelles, dont l'âge, la fréquence cardiaque avant le traitement, le nombre d'ondes de choc reçues pendant le traitement, le niveau d'énergie établi pour le lithotriteur, le sexe, la présence d'une endoprothèse urétérale, le recours antérieur à une LECOC et le côté traité. Résultats : Les dysrythmies cardiaques ont été plus fréquentes chez les patients plus jeunes et les personnes traitées pour des calculs du côté droit. Les autres variables n'ont eu aucun effet sur la probabilité de survenue de DC. Toutes les DC se sont résorbées rapidement après conversion par synchronisation à l'électrocardiographie (ECG). Conclusion : Un âge moins avancé et un traitement du côté droit prédisposent les pat...

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“…La membrana metálica está cargada eléctricamente del mismo signo que la bobina; al pasar la corriente magnética, se desplaza con un movimiento brusco de repulsión, lo que genera presión suficiente para formar la onda de choque. La focalización se hace por lentes acústicas o reflector parabólico metálico 1,4 . La onda de choque es constante y la energía es dirigida a un pequeño punto focal con alta energía 5 .…”

Section: C) Litotriptor Electromagnético (Figura 5)unclassified

“…El tratamiento de un hematoma subcapsular generalmente es conservador: analgésicos, control estrecho de creatinina sérica y hematócrito en serie. Si este tratamiento no es suficiente y el paciente no se estabiliza, se recurre a la cirugía abierta 1,13,18 . La experiencia muestra que la posibilidad de perder un riñón cuando se hace necesario operar es elevada.…”

Section: Figura 5 Litotriptor Electromagnético (Tercera Generaciónunclassified

Litotripsia extracorpórea por ondas de choque en niños. A propósito de un caso complicado

Alvarado-García¹,

Mundo-Alegría²

2014

Acta Pediatr Mex

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Este artículo debe citarse como: Alvarado-García R, Mundo-Alegría AX. Litotripsia extracorpórea por ondas de choque en niños. A propó-sito de un caso complicado. Acta Pediatr Mex 2010;31(3):95-101. www.nietoeditores.com.mx RESUMENLa litotripsia extracorpórea es un procedimiento eficaz en el tratamiento de litiasis renal y ureteral. En pediatría ha adquirido gran aceptación por la facilidad del procedimiento, mayor disponibilidad de litotriptores y acortamiento de la estancia hospitalaria. Sin embargo, las complicaciones que puede desarrollar el paciente pediátrico pueden variar desde las sintomáticas (dolor) hasta las que comprometen la función renal. Presentamos el caso de una adolescente de 15 años de edad con litiasis renal bilateral que fue sometida a una sesión de litotripsia extracorpórea. Esta intervención causó un hematoma renal izquierdo, que se visualizó con ultrasonido y tomografía computada renal. Se trató en forma conservadora y el hematoma desapareció 13 semanas después. Cuatro semanas después la paciente desarrolló hipertensión arterial sistémica; hubo disminución de la tasa de filtración glomerular en el riñón ipsilateral que cedieron posteriormente. La litotripsia extracorpórea en pediatría es eficaz para el tratamiento de litiasis renal y ureteral. Es un procedimiento sencillo y rápido. El desarrollo de un hematoma renal es una complicación infrecuente, menor al 1%. La monitorización y el seguimiento clínico del paciente permiten identificarla y tratarla oportunamente. Palabras clave: Litotripsia, litiasis, hematoma renal, hipertensión arterial. ABSTRACTExtracorporeal shock wave lithotripsy is an effective procedure for the treatment of renal and ureteral lithiasis. In pediatrics has become widely accepted by the facility of the procedure, availability of lithotripters and faster discharge from hospital. However, complications in pediatric patients can vary from symptomatic (pain) to a compromise renal function. We present a case of a 15 year old female adolescent with bilateral renal lithiasis which underwent for extracorporeal shock wave lithotripsy session which was complicated by a left renal hematoma, confirmed by renal ultrasonography and computerized tomography scan. Conservative management was established and the hematoma became stabilized. The patient developed hypertension and glomerular filtration rate was decreased on the ipsilateral kidney four weeks after the procedure which had spontaneous resolution. Pediatric extracorporeal shock wave lithotripsy is an effective procedure for the treatment of renal and ureteral calculi; its advantages are easiness, speed and accessibility. A renal hematoma as a complication occurs in less than 1%. Patient monitoring and follow-up identified timely this complication.

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Extracorporeal shock-wave lithotripsy (ESWL) for treatment of urolithiasis

Cited by 304 publications

References 7 publications

Effect of shock waves on suspended and immobilized L1210 cells

Effect of shock waves on suspended and immobilized L1210 cells

Variables influencing the likelihood of cardiac dysrhythmias during extracorporeal shock wave lithotripsy

Litotripsia extracorpórea por ondas de choque en niños. A propósito de un caso complicado

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