Yürük Emrah, Binbay Murat, Akman Tolga, Özgör Faruk, Berberoğlu Yalçın, Müslümanoğlu Ahmet Yaser
Department of Urology, Haseki Training and Research Hospital, İstanbul, Turkey.
Turk J Urol. 2014 Dec;40(4):211-5. doi: 10.5152/tud.2014.83446.
Shock-wave lithotripsy (SWL) is the first-line treatment for the active removal of small and medium-sized kidney stones. Flexible ureterorenoscopy (fURS) is recommended after failed SWL treatment. The aim of this retrospective analysis is to evaluate whether prior unsuccessful SWL treatments affect the outcomes of fURS.
Data from 206 patients who underwent fURS for the treatment of renal stones between September 2009 and January 2011 were collected, and the patients were divided into two groups according to their previous SWL treatment. The patient demographics, stone characteristics, operation and fluoroscopy times, stone-free rates and complications were compared.
Of the patients, 114 (55.3%) did not undergo SWL prior to fURS (Group 1), whereas 92 (44.6%) completed a minimum of 3 sessions of SWL and waited at least 2 weeks before the fURS operation (Group 2). Although the mean stone number was higher in Group 2, this difference was not significant (p=0.06). The mean operation (p=0.12) and fluoroscopy times (p=0.69) were similar between the groups. The mean operation time per mm(2) stone and fluoroscopy time per mm(2) stone were not significantly different (p=0.64 and p=0.76, respectively). The length of the hospitalization and the overall complication rates were similar. After the third postoperative month, the stone-free rates were not different between the groups (82.5% and 86.9%, respectively, p=0.38).
The stone-free and complication rates of fURS were not affected by previous SWL therapy.
冲击波碎石术(SWL)是主动清除中小型肾结石的一线治疗方法。SWL治疗失败后推荐使用软性输尿管肾镜检查(fURS)。本回顾性分析的目的是评估先前SWL治疗失败是否会影响fURS的治疗效果。
收集了2009年9月至2011年1月期间接受fURS治疗肾结石的206例患者的数据,并根据其先前的SWL治疗情况将患者分为两组。比较了患者的人口统计学特征、结石特征、手术和透视时间、无结石率及并发症。
在这些患者中,114例(55.3%)在fURS治疗前未接受SWL治疗(第1组),而92例(44.6%)至少完成了3次SWL治疗,并在fURS手术前至少等待了2周(第2组)。虽然第2组的平均结石数量较多,但差异无统计学意义(p = 0.06)。两组间的平均手术时间(p = 0.12)和透视时间(p = 0.69)相似。每平方毫米结石的平均手术时间和每平方毫米结石的透视时间差异无统计学意义(分别为p = 0.64和p = 0.76)。住院时间和总体并发症发生率相似。术后第三个月后,两组间的无结石率无差异(分别为82.5%和86.9%,p = 0.38)。
先前的SWL治疗对fURS的无结石率和并发症发生率没有影响。