Department of Urology, Ijinkai Takeda General Hospital, 28-1 Ishida Moriminami-cho, Fushimi-ku, Kyoto, 601-1495, Japan.
Urolithiasis. 2022 Oct;50(5):635-641. doi: 10.1007/s00240-022-01351-0. Epub 2022 Aug 15.
To elucidate and compare the efficacy and safety of the reduced (30 shocks/min with 1200 shocks/session) and standard protocols (60 shocks/min with 2400 shocks/session) of extracorporeal shockwave lithotripsy (SWL) for ureteral stones treatment. This study was a retrospective review of 2410 SWL procedures with reduced or standard protocols (groups R and S) in 1106 patients for ureteral stones between March 2014 and March 2021. The primary outcome was treatment success, defined as the absence of residual fragments on ultrasonography and plain radiography within 30 and 90 days. A multivariate logistic regression and propensity score matching analysis evaluated the association between the reduced protocol and treatment success. This study included 311 and 544 patients in the reduced (R) and standard (S) protocol groups, respectively. The patient's characteristics were comparable, excluding the lithotripter machine. No significant difference was observed between groups R and S in treatment success rates within 30 (63.3 vs. 65.8%, p = 0.50) and 90 days (88.7 vs. 91.5%, p = 0.18). The multivariate analysis indicated no significant association between reduced protocol and treatment success within 30 and 90 days (p = 0.44 and p = 0.68, respectively). Propensity score matching showed no significant difference in the treatment success rates within 30 and 90 days. The Extremely slow, half number protocol outcomes are comparable to those of the standard protocol for treating ureteral stones.
为了阐明和比较体外冲击波碎石术(SWL)减少(30 次/分钟,1200 次/次)和标准方案(60 次/分钟,2400 次/次)治疗输尿管结石的疗效和安全性。本研究回顾性分析了 2014 年 3 月至 2021 年 3 月期间 1106 例输尿管结石患者接受减少或标准方案(R 组和 S 组)的 2410 例 SWL 治疗的结果。主要结局是治疗成功,定义为 30 天和 90 天超声和 X 线平片无残留碎片。多变量逻辑回归和倾向评分匹配分析评估了减少方案与治疗成功之间的关系。本研究包括减少组(R 组)和标准组(S 组)各 311 例和 544 例患者。患者的特征具有可比性,除了碎石机。在 30 天(63.3%比 65.8%,p=0.50)和 90 天(88.7%比 91.5%,p=0.18)的治疗成功率方面,R 组和 S 组之间无显著差异。多变量分析表明,减少方案与 30 天和 90 天的治疗成功率无显著相关性(p=0.44 和 p=0.68)。倾向评分匹配显示,30 天和 90 天的治疗成功率无显著差异。极慢,减半方案的结果与标准方案治疗输尿管结石的结果相当。