Department of Pediatric Surgery, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey.
Urolithiasis. 2013 Oct;41(5):431-6. doi: 10.1007/s00240-013-0574-7. Epub 2013 Jun 1.
An experimental study was carried out to evaluate the effects of extracorporeal shock wave lithotripsy (ESWL) on contralateral kidney, liver and lung by histopathological and biochemical methods. Twelve New Zealand rabbits were allocated to two groups (n = 6). Tissues of control group (CG, n = 6) were harvested without any intervention. In ESWL group (EG), right kidneys were exposed to 3,000 shock waves at 14 kV energy using electro-hydraulic type ESWL device three times every other day. Both kidneys, liver, and right lobe of lung tissues in EG were harvested on seventh day. Kidneys were examined histopathologically for presence of glomerular and tubular injury, interstitial edema, congestion, inflammation and fibrosis. Livers were examined for hepatocyte vacuolization, congestion, portal inflammation and fibrosis. Lung tissues were examined for loss of normal structure, emphysema, interstitial congestion-edema, prominent alveolar septal vessels, interstitial inflammation, intra-alveolar hemorrhage, intraluminal hemorrhage, peribronchial edema, congestion, inflammation in bronchial wall and epithelial desquamation. Biochemical analysis of tissue samples was performed for oxidative injury markers. Histopathological evaluations revealed that tubular injury was found in both shocked and contralateral kidneys (p < 0.05). EG showed higher grades of portal fibrosis in liver and higher grades of peribronchial congestion in lung when compared to CG (p < 0.05). Biochemical evaluations of both kidneys showed that malondialdehyde levels were higher in EG than in CG (p < 0.05). ESWL causes histopathologic alterations both in shocked and contralateral kidneys. Extrarenal tissues such as liver and lung can be affected by shock waves histopathologically and oxidative injury of contralateral kidney may occur acutely after ESWL.
一项实验研究通过组织病理学和生化方法评估了体外冲击波碎石术（ESWL）对对侧肾脏、肝脏和肺的影响。将 12 只新西兰兔分为两组（n=6）。对照组（CG，n=6）的组织未经任何干预即被采集。在 ESWL 组（EG）中，使用液电式 ESWL 设备每天两次对右肾进行 3000 次冲击，每次冲击能量为 14kV。EG 组于第 7 天采集双侧肾脏、肝脏和右肺组织。对肾脏进行组织病理学检查，观察肾小球和肾小管损伤、间质水肿、淤血、炎症和纤维化情况。检查肝脏是否存在肝细胞空泡化、淤血、门脉炎症和纤维化。观察肺组织是否有正常结构丧失、肺气肿、间质淤血-水肿、肺泡间隔血管突出、间质炎症、肺泡内出血、管腔内出血、支气管周围水肿、淤血、支气管壁炎症和上皮脱落。对组织样本进行生化分析，评估氧化损伤标志物。组织病理学评估显示，冲击侧和对侧肾脏均出现肾小管损伤（p<0.05）。与 CG 相比，EG 组的肝脏门静脉纤维化程度更高，肺的支气管周围淤血程度更高（p<0.05）。对双侧肾脏的生化评估显示，EG 组的丙二醛水平高于 CG 组（p<0.05）。ESWL 可导致冲击侧和对侧肾脏的组织病理学改变。冲击波还可导致肾脏以外的组织（如肝脏和肺）发生组织病理学改变，ESWL 后对侧肾脏可能会发生急性氧化损伤。
