Rassweiler J J, Renner C, Chaussy C, Thüroff S
Department of Urology, Klinikum Heilbronn GmbH, University of Heidelberg, Germany.
Eur Urol. 2001 Feb;39(2):187-99. doi: 10.1159/000052435.
Despite the extensive experience with minimal invasive stone therapy, there are still different views on the ideal management of renal stones.
Analysis of the literature includes more than 14,000 patients. We have compared these data with long-term results of two major stone centers in Germany. The results have been compared concerning the anatomical kidney situation, stone size, stone localization and observation time.
According to the importance of residual fragments following extracorporeal shock wave lithotripsy (ESWL), we have to distinguish between clinically insignificant residual fragments and clinically significant residual fragments (CIRF). 24 months following ESWL stone passage occurs as a continuous process, and if there are no clinical symptoms, any endoscopic procedure should be considered as overtreatment. According to these results, stone-free rates of patients increase in longer follow-up periods. Newer ESWL technology has increased the percentage of CIRF.
We consider ESWL in most patients with renal calculi as first-line treatment, except in patients with renal calculi bigger than 30 mm in diameter.
尽管在微创结石治疗方面有丰富经验，但对于肾结石的理想治疗方法仍存在不同观点。
对超过14000例患者的文献进行分析。我们将这些数据与德国两个主要结石中心的长期结果进行了比较。对肾脏解剖情况、结石大小、结石位置和观察时间的结果进行了比较。
根据体外冲击波碎石术（ESWL）后残留碎片的重要性，我们必须区分临床意义不显著的残留碎片和临床意义显著的残留碎片（CIRF）。ESWL后24个月结石排出是一个持续的过程，如果没有临床症状，任何内镜手术都应被视为过度治疗。根据这些结果，患者的无石率在更长的随访期内会增加。更新的ESWL技术增加了CIRF的比例。
我们认为，除直径大于30mm的肾结石患者外，大多数肾结石患者的ESWL应作为一线治疗方法。
