Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
J Endourol. 2012 May;26(5):484-8. doi: 10.1089/end.2011.0386. Epub 2012 Jan 4.
Endoscopic lithotripsy is often prolonged secondary to the retrograde migration of calculous fragments. Various balloons, baskets, and other devices have been used to prevent this migration. Our purpose is to analyze the effect of the Accordion(®) on stone migration and overall efficiency during lithotripsy.
We prospectively evaluated 21 patients with a total of 23 distal ureteral stones. Patients underwent lithotripsy using an endoscopic impact lithotriptor. The Accordion was randomly used in 11 of these 21 patients. Data were collected regarding stone migration, stone size, stone ablation, ureteral clearing, and lengths of time for various stages of each procedure.
Patients who were treated with the Accordion device experienced significantly less retrograde migration during fragmentation (P=0.0064). When stone volume was taken into account (but not on a per stone basis), ablation and ureteral clearing were also expedited, and fewer lithotripter "hits" and basket "sweeps" were needed.
The Accordion device is effective in preventing the migration of stone fragments during endoscopic ureteral lithotripsy. Our data suggest that this device may also increase efficiency of the fragmentation and clearance of ureteral calculi.
由于结石碎片逆行迁移，经内镜碎石术常被延长。各种球囊、篮筐和其他设备已被用于防止这种迁移。我们的目的是分析 Accordion（®）在碎石术过程中对结石迁移和整体效率的影响。
我们前瞻性评估了 21 名共 23 例远端输尿管结石患者。患者接受内镜冲击碎石术。21 名患者中有 11 名随机使用 Accordion。收集了有关结石迁移、结石大小、结石消融、输尿管通畅以及各个阶段所需时间的数据。
使用 Accordion 设备的患者在碎石过程中逆行迁移明显减少（P=0.0064）。当考虑结石体积（而不是基于每块结石）时，消融和输尿管通畅也得到了加快，碎石器“撞击”和篮筐“扫荡”的次数也减少了。
Accordion 设备可有效防止内镜输尿管碎石术中结石碎片的迁移。我们的数据表明，该设备还可能提高输尿管结石碎石和清除的效率。
