Ergin Giray, Kirac Mustafa, Kopru Burak, Ebiloglu Turgay, Kibar Yusuf, Biri Hasan
Department of Urology, Koru Ankara Hospital, Ankara, Turkey.
Department of Urology, Gulhane Training and Research Hospital, Ankara, Turkey.
Ir J Med Sci. 2018 Nov;187(4):1121-1126. doi: 10.1007/s11845-018-1776-3. Epub 2018 Mar 3.
To compare shock wave lithotripsy and flexible ureteroscopy in children with renal stone's diameter of 10 to 20 mm.
This is a retrospective study including 79 children, who had renal stone and underwent either shock wave lithotripsy or flexible ureteroscopy between January 2007 and June 2017. Of those, 38 patients underwent shock wave lithotripsy assigned as group 1 and 41 patients underwent flexible ureteroscopy assigned as group 2. Stone-free rate, fluoroscopy time, procedure time, complication rates, hospitalization time, and cost-effectiveness were monitored and included in the analyses.
The mean patient age was 4.4 ± 3.5 in group 1 and 4.9 ± 4.1 in group 2. Stone-free rate was not different in both groups in the first and third months of follow-up. The mean fluoroscopy time was statistically significantly longer in group 1 compared to group 2. Procedure and hospitalization times were longer in group 2 compared to group 1. No complications were seen in either groups. The expenditure was calculated as 135.23 and 869.41 Euro per patient for groups 1 and 2, respectively, which shows significant higher cost in group 2.
In this present study, we have shown that shock wave lithotripsy is cheaper, has short hospitalization time and long fluoroscopy time and similar stone-free rate, and has the same efficiency compared to flexible ureteroscopy regarding pediatric renal stones with the diameter between 10 and 20 mm.
比较冲击波碎石术与软性输尿管镜术治疗直径为10至20毫米肾结石患儿的效果。
这是一项回顾性研究，纳入了79例患有肾结石且在2007年1月至2017年6月期间接受冲击波碎石术或软性输尿管镜术的患儿。其中，38例患者接受冲击波碎石术，分为第1组；41例患者接受软性输尿管镜术，分为第2组。监测无石率、透视时间、手术时间、并发症发生率、住院时间和成本效益，并纳入分析。
第1组患者的平均年龄为4.4±3.5岁，第2组为4.9±4.1岁。在随访的第一个月和第三个月，两组的无石率无差异。第1组的平均透视时间在统计学上显著长于第2组。第2组的手术时间和住院时间比第1组长。两组均未出现并发症。第1组和第2组每位患者的费用分别计算为135.23欧元和869.41欧元，这表明第2组的费用显著更高。
在本研究中，我们表明，对于直径在10至20毫米的小儿肾结石，与软性输尿管镜术相比，冲击波碎石术成本更低，住院时间短，透视时间长，无石率相似，且效率相同。
