Sfoungaristos Stavros, Gofrit Ofer N, Pode Dov, Landau Ezekiel H, Yutkin Vladimir, Latke Arie, Duvdevani Mordechai
Department of Urology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Prague Med Rep. 2015;116(3):225-32. doi: 10.14712/23362936.2015.62.
To evaluate the impact of ureteral stenting history to the outcomes of extracorporeal shockwave lithotripsy, we retrospectively analysed patients who underwent shockwave lithotripsy with Dornier Gemini lithotripter between September 2010 and August 2012. Forty seven patients (group A) who had a double J stent which was removed just before the procedure were matched-paired with another 47 patients (group B) who underwent shockwave lithotripsy having no stent history. The correlation between ureteral stenting history and stone-free rates was assessed. Stone-free rates were 68.1% and 87.2% for patients of group A and B, respectively (p=0.026). Postoperative complications were not different between groups. Multivariate analysis revealed that stone size (p=0.007), stone location (p=0.044) and history of ureteral stenting (p=0.046) were independent predictors for stone clearance after shockwave lithotripsy. Ureteral stents adversely affect shockwave lithotripsy outcome, even if they are removed before the procedure. Stenting history should divert treatment plan towards intracorporeal lithotripsy.
为评估输尿管支架置入史对体外冲击波碎石术治疗效果的影响，我们回顾性分析了2010年9月至2012年8月期间使用多尼尔双子星碎石机接受冲击波碎石术的患者。将47例（A组）在手术前刚刚取出双J支架的患者与另外47例（B组）无支架置入史且接受冲击波碎石术的患者进行配对。评估输尿管支架置入史与结石清除率之间的相关性。A组和B组患者的结石清除率分别为68.1%和87.2%（p = 0.026）。两组术后并发症无差异。多因素分析显示，结石大小（p = 0.007）、结石位置（p = 0.044）和输尿管支架置入史（p = 0.046）是冲击波碎石术后结石清除的独立预测因素。输尿管支架即使在手术前取出，也会对冲击波碎石术的效果产生不利影响。有支架置入史的患者应将治疗方案转向体内碎石术。
