Kartal Training and Research Hospital, Department of Urology, Istanbul, Turkey.
Urology. 2011 Dec;78(6):1402-6. doi: 10.1016/j.urology.2011.08.005. Epub 2011 Oct 2.
To evaluate the treatment parameters of shockwave lithotripsy (SWL) in lower calyceal calculi in adults and children in a comparative manner.
Between 2006 and 2011, SWL was performed for lower calyceal calculi in 282 adults (mean age 48.5 years, range 28-64) and 54 children (mean age 48 months, range 5-141). The Wolf Piezolith 3000 lithotriptor has been used for SWL. Success rates, auxiliary procedures, additional interventions, and complications were evaluated in detail in a comparative manner.
Mean stone size was 7.7 mm (range 5-25) and 8.1 mm (range 5-23) in children and in adults, respectively. Mean SWL sessions were 1.5 (range 1-5) in children and 2.4 (range 1-6) in adults. Although 66.6% of children were stone-free after the first session, 28% of adult patients were stone-free after the first SWL session, showing a statistically significant difference (P = .0001). After the treatments, although a complete stone-free status was obtained in 85% of children, 31.5% of adults were stone-free at 3-month follow-up after SWL (P = .0001). Although no auxiliary procedures were needed in children, 8.2% of adults required them. Likewise, the percentage of additional procedures were higher in adults than children (20.2%).
SWL for lower calyceal calculi has been found to be highly successful in pediatric patients. These results demonstrate that, irrespective of stone size, SWL should be the first treatment alternative in the management of lower calyx stones in children.
以对比的方式评估成年人和儿童的冲击波碎石术（SWL）治疗参数。
在 2006 年至 2011 年间，对 282 例成年人（平均年龄 48.5 岁，范围 28-64 岁）和 54 例儿童（平均年龄 48 个月，范围 5-141 岁）的下盏结石进行了 SWL。采用 Wolf Piezolith 3000 碎石机进行 SWL。以对比的方式详细评估成功率、辅助程序、额外干预和并发症。
儿童和成年人的平均结石大小分别为 7.7mm（范围 5-25）和 8.1mm（范围 5-23）。儿童 SWL 次数平均为 1.5 次（范围 1-5），成年人平均为 2.4 次（范围 1-6）。尽管 66.6%的儿童在第一次治疗后结石完全消失，但 28%的成年患者在第一次 SWL 后结石完全消失，差异有统计学意义（P=0.0001）。治疗后，尽管 85%的儿童结石完全消失，但 3 个月随访时 31.5%的成年患者结石完全消失（P=0.0001）。尽管儿童不需要辅助程序，但 8.2%的成年患者需要。同样，成人的附加程序百分比高于儿童（20.2%）。
SWL 治疗下盏结石在儿科患者中非常成功。这些结果表明，无论结石大小如何，SWL 都应成为儿童下盏结石治疗的首选方法。
