Extrakorporale Stoßwellenlithotripsie

Klein, Jan-Thorsten; Netsch, Christopher; Sievert, K.D.; Miernik, Arkadiusz; Westphal, J.; Leyh, Herbert; Herrmann, T.R.W.; Olbert, P.; Häcker, Axel; Bachmann, Annette; Homberg, Roland; Schoenthaler, Martin; Rassweiler, Jens; Gross, Andreas J.

doi:10.1007/s00120-018-0611-9

Cited by 7 publications

(4 citation statements)

References 29 publications

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“…ESWL is a noninvasive approach for treating stones using an extracorporeal lithotripter to target and emit shock waves repeatedly to break up the stones and allow their evacuation from urine [ 12 ]. However, there are concerns about the complications associated with high-energy shock waves [ 13 ]. Accordingly, this study was conducted to evaluate the clinical efficacy of ESWL for urinary calculi and precautions for postoperative complications.…”

Section: Introductionmentioning

confidence: 99%

The Clinical Efficacy and Safety of Extracorporeal Shock Wave Lithotripsy in the Treatment of Patients with Urinary Calculi

et al. 2022

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Objective. To evaluate the clinical efficacy of extracorporeal shock wave lithotripsy (ESWL) for urinary calculi and precautions of postoperative complications. Methods. 90 patients with urinary calculi at our hospital were randomly recruited between July 2019 and July 2020 and were allocated (1 : 1) to receive either ESWL (observation group) or conventional surgery (control group). Clinical efficacy was the primary endpoint, whereas adverse events were the secondary endpoint. Results. The operation time, early activity time, and hospitalization time of the observation group were significantly lower than those of the control group ( P < 0.05 ). ESWL resulted in less postoperative pain in patients versus conventional surgery ( P < 0.05 ). ESWL was associated with a significantly higher total clinical efficacy (97.78%) versus conventional surgery (82.22%) ( P < 0.05 ). The eligible patients given ESWL had a lower incidence of complications (11.12%) versus those given conventional surgery (31.12%) ( P < 0.05 ). Conclusion. Hematuria prevention requires precise localization of stones as well as adjustment of pulse energy and the number of impacts due to stone changes. Precautions against renal colic necessitate complete comminution of stones intraoperatively, more postoperative water intake, moderate exercise, or injection of antispasmodic drugs and cathartics for pain relief. Nausea and vomiting precautions require preoperative recording of previous medical history and corresponding treatment, intraoperative real-time adjustment of voltage pulse frequency, and duration depending on the magnitude of intraoperative reaction. Urinary tract infection prevention requires preoperative prevention and proper postoperative anti-infection and anti-inflammatory treatment, along with enough water intake and bed rest. Other precautions include thorough comminution of the calculi, proper anti-infection and anti-inflammatory treatment, no early exercise or excessive activity after surgery, and proper postoperative care. ESWL is effective in treating patients with urinary calculi with a simple, safe, and quick operation and a low incidence of adverse events, as it effectively reduces the incidence of complications, accelerates the recovery of patients and improves their quality of life.

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Section: Introductionmentioning

confidence: 99%

The Clinical Efficacy and Safety of Extracorporeal Shock Wave Lithotripsy in the Treatment of Patients with Urinary Calculi

et al. 2022

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“…Im letzten Jahrzehnt hat die Miniaturisierung und die digitale Videotechnologie zur Dominanz der endourologischen Techniken über die ESWL geführt [52,72,73]. Auch mit flexiblen Ureterorenoskopen kann heutzutage unter optimaler Bildqualität der Stein lokalisiert und entsprechend behandelt werden [74].…”

Section: Aktuelle Situation Der Endourologieunclassified

50 Jahre Minimal-invasive Chirurgie in der Urologie

et al. 2019

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ZusammenfassungDie Entwicklung der Minimal-invasiven Chirurgie (MIC) in der Urologie umfasst die Teilbereiche transurethrale Techniken, Endourologie und Extrakorporale Stosswellenlithotripsie, Uroradiologie sowie Laparoskopie und Robotische Chirurgie. Basierend auf persönlichen Erfahrungen mit der Entwicklung minimal-invasiver Verfahren seit Ende der 70iger Jahren präsentieren wir eine historische Analyse der Literatur mit dem Ziel, die wesentlichen Meilensteine der Minimal-Invasiven Therapie in der Urologie herauszuarbeiten.Motor der rasanten Entwicklung der MIC in der Urologie war die Einführung der digitalen Videotechnologie, Lasertechnologie, Fortschritte der Elektrochirurgie begleitet von den Glanzleistungen vor allem Deutscher Technologiefirmen mit zunehmender Miniaturisierung des Instrumentariums. Bedeutsam war auch die gute Kooperation zwischen Urologen, Ingenieuren und Radiologen.Die Laparoskopie wird trotz zahlreicher Weiterentwicklungen (3D-Prismentechnolgie, ETHOS-chair) zunehmend von der Robotik ersetzt. Auf Grund der auslaufendenden Patenten von Intuitive Surgical existiert seit diesem Jahr eine Konkurrenzsituation mit neuen Herstellern von Operationsrobotern. Allerdings müssen diese erst belegen, ob sie den hohen Qualitätsstandard der aktuellen Da Vinci-serie bieten können. Robotersysteme für die Endourologie werden zukünftig eine Rolle spielen, wie Avicenna RoboflexR für die flexible Ureteroskopie und AquaBeamR- für die roboter-assistierte Aquaablation der Prostata. Während RoboflexR ähnlich dem Da Vinci-system die Ergonomie des Eingriffes erleichtert, ersetzt die robotergestützte Aquablation erstmals den Operateur.

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“…Based on these considerations, we performed a case–control study, aiming to evaluate (i) MD adherence and the dietary salt intake in stone-forming patients (SF) and in non-stone forming controls (NSF); (ii) the relationship occurring between MD adherence, salt intake, and NL-related metabolic risk factors; and (iii) the impact of combined high MD adherence and low salt intake on NL susceptibility. We enrolled SF treated with extracorporeal shock wave lithotripsy (ESWL), which is frequently used as a cost-effective treatment for NL [ 25 , 27 , 28 , 29 , 30 ], and NSF living in a geographical area that features a high incidence of NL: the Campania region in Southern Italy [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Adherence to Mediterranean Diet, Dietary Salt Intake, and Susceptibility to Nephrolithiasis: A Case–Control Study

Abate,

Vergatti,

Iaccarino Idelson

et al. 2024

Nutrients

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Unhealthy dietary habits play a key role in the pathogenesis of nephrolithiasis (NL). The aims of this case–control study were to evaluate (i) the adherence to the Mediterranean Diet (MD) and the dietary salt intake in stone-forming patients (SF), (ii) the relationship occurring between MD adherence, salt intake and NL-related metabolic risk factors in SF, and (iii) the impact of combined high MD adherence and low salt intake on NL susceptibility. From 1 January 2018 to 31 December 2019, we recruited all SF consecutively referred to the Extracorporeal Shock Wave Lithotripsy (ESWL) center of Federico II University, and at least two control subjects without a personal history of NL, age-, sex-, and body mass index-matched to SF (NSF). All study participants were interviewed using the validated MEDI-LITE and MINISAL questionnaires. In an SF subgroup, the NL-related metabolic risk factors were also evaluated. SF showed a lower MD adherence and a higher salt intake compared with NSF. The NL susceptibility decreased by 36% [OR: 0.64 (0.59–0.70); p < 0.01] for each point of increase in MEDI-LITE score, while it increased by 13% [OR: 1.13 (1.03–1.25); p = 0.01] for each point of increase in MINISAL score. The SF prevalence was higher among subjects showing combined low MD adherence and high salt intake. In SF, the MEDI-LITE score directly correlated with 24 h-citraturia, whereas the MINISAL score directly correlated with urinary sodium and uric acid excretion. In conclusion, high MD adherence and low salt intake are associated with a reduced NL susceptibility, both separately and in combination.

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Extrakorporale Stoßwellenlithotripsie

Cited by 7 publications

References 29 publications

The Clinical Efficacy and Safety of Extracorporeal Shock Wave Lithotripsy in the Treatment of Patients with Urinary Calculi

The Clinical Efficacy and Safety of Extracorporeal Shock Wave Lithotripsy in the Treatment of Patients with Urinary Calculi

50 Jahre Minimal-invasive Chirurgie in der Urologie

Adherence to Mediterranean Diet, Dietary Salt Intake, and Susceptibility to Nephrolithiasis: A Case–Control Study

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