Ackermann D, Claus R, Zehntner C, Scheiber K
Department of Urology, University of Berne, Switzerland.
Eur Urol. 1988;15(1-2):5-8. doi: 10.1159/000473384.
The complications after extracorporeal shock wave lithotripsy (ESWL) for large renal calculi could be reduced by insertion of ureteral stents. In a prospective study, the critical stone size for ESWL combined with ureteral stenting was looked for. Sixty consecutive patients entered the study, 17 patients suffered from renal calculi with a length of greater than 4 cm and a width of greater than 3 cm (group 1), and in 43 patients the calculi measured between 4 x 3 and 2.5 x 1.5 cm2 (group 2). ESWL was performed with the Dornier apparatus HM-3. A ureteral stent was placed immediately before ESWL. In group 1 with very large stones, significantly more obstructive problems were encountered. Three months after ESWL, only 6 of 14 (43%) were free of stones or with stone material likely to discharge spontaneously. In group 2, a success rate of 25 of 29 (86%) was noticed, which was considered satisfactory. For most stones greater than 4 x 3 cm2 the combination of percutaneous nephrolithotomy and ESWL seems to be the preferred treatment.
通过插入输尿管支架可减少体外冲击波碎石术（ESWL）治疗大型肾结石后的并发症。在一项前瞻性研究中，探寻了ESWL联合输尿管支架置入术的临界结石大小。连续60例患者进入该研究，17例患者患有长度大于4 cm且宽度大于3 cm的肾结石（第1组），43例患者的结石尺寸在4×3至2.5×1.5 cm²之间（第2组）。使用多尼尔HM - 3设备进行ESWL。在ESWL前立即置入输尿管支架。在结石非常大的第1组中，遇到的梗阻性问题明显更多。ESWL三个月后，14例中只有6例（43%）无结石或结石物质可能自行排出。在第2组中，观察到29例中有25例（86%）的成功率，这被认为是令人满意的。对于大多数大于4×3 cm²的结石，经皮肾镜取石术与ESWL联合似乎是首选治疗方法。
