Gnanapragasam V J, Ramsden P D, Murthy L S, Thomas D J
Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK.
BJU Int. 1999 Nov;84(7):770-4. doi: 10.1046/j.1464-410x.1999.00284.x.
To review the results of primary in situ extracorporeal shock wave lithotripsy (ESWL) for the treatment of ureteric stones using a third-generation lithotripter, the Dornier MFL 5000 (Dornier Medizentechnic, Germany).
The study comprised a retrospective review of treatment outcome in 180 patients with 196 stones who were treated with primary in situ ESWL, assessing the success of this approach and establishing reasons for failure.
At the 3-month follow-up, 88% of patients were stone-free; 21 patients failed ESWL and were treated by ureteroscopic stone extraction with no complications. Stone-free rates were 90% for upper ureteric, 89% for middle-third and 86% for lower-third calculi. Twenty-one patients required auxiliary procedures in the form of JJ stenting or nephrostomy. Failure of ESWL was associated with stone size (>1.3 cm) but not location or inadequate treatment.
Where prompt access to ESWL is available, primary in situ ESWL remains an effective form of treatment for all ureteric calculi, although stone-free rates are lower for larger stones.
回顾使用第三代碎石机多尼尔MFL 5000（德国多尼尔医疗技术公司）进行原发性原位体外冲击波碎石术（ESWL）治疗输尿管结石的结果。
本研究对180例患有196颗结石并接受原发性原位ESWL治疗的患者的治疗结果进行回顾性分析，评估该方法的成功率并确定失败原因。
在3个月的随访中，88%的患者结石清除；21例ESWL治疗失败的患者接受输尿管镜取石术，无并发症。上段输尿管结石的结石清除率为90%，中段为89%，下段为86%。21例患者需要以双J管支架置入或肾造瘘术的形式进行辅助治疗。ESWL治疗失败与结石大小（>1.3 cm）有关，与结石位置或治疗不充分无关。
在能够及时进行ESWL治疗的情况下，原发性原位ESWL仍然是治疗所有输尿管结石的有效方法，尽管较大结石的结石清除率较低。
