Singh Nimisha, Agarwal Shikhar, Sarpal Rajeev
General Surgery, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, IND.
Plastic and Reconstructive Surgery, Jawaharlal Nehru Medical College (JNMC) Aligarh Muslim University (AMU), Aligarh, IND.
Cureus. 2024 May 26;16(5):e61102. doi: 10.7759/cureus.61102. eCollection 2024 May.
Extracorporeal shockwave lithotripsy (ESWL) is a widely accepted non-invasive treatment for renal and upper ureteric stones smaller than 2 cm due to its safety and efficacy. Despite advancements in minimally invasive techniques, extracorporeal shockwave lithotripsy remains an important modality.
This prospective observational study aimed to evaluate the outcomes of ESWL in managing renal and upper ureteric stones measuring less than 2 cm in terms of stone clearance.
In a study conducted at a university-affiliated tertiary care hospital, 119 patients with renal and upper ureteric stones underwent extracorporeal shockwave lithotripsy over a 12-month period. Data on patient demographics, stone characteristics, treatment procedures, and complications were collected. Follow-up assessments were performed at two-week intervals for up to two months post-treatment.
The mean age of patients was 39.78 years, with a mean stone size of 1.2 cm. Right kidney stones were more prevalent (61.3% [n=76]). Complications included fever (19.3% [n=23]), gross haematuria (24.3% [n=29]), and steinstrasse (21.8% [n=26]). The success rate of extracorporeal shockwave lithotripsy was 81.5% (n=97), with 18.5% (n=22) of patients requiring surgical intervention due to incomplete fragmentation or residual fragments >4 mm. Stone size and density played significant roles in treatment success.
Despite advancements in minimally invasive techniques, ESWL retains its significance as a noninvasive and effective treatment option for renal and upper ureteric stones smaller than 2 cm. Its success depends on various factors, including the stone site, size, and composition. ESWL offers advantages such as minimal morbidity, shorter hospital stays, and better patient compliance. Complications such as steinstrasse are manageable with conservative measures or ancillary procedures. While ESWL may be losing ground in some cases, its noninvasive nature and favourable outcomes make it a valuable option in the armamentarium for stone management.
体外冲击波碎石术（ESWL）因其安全性和有效性，是一种被广泛接受的针对小于2厘米的肾及上段输尿管结石的非侵入性治疗方法。尽管微创技术有所进步，但体外冲击波碎石术仍然是一种重要的治疗方式。
这项前瞻性观察性研究旨在评估体外冲击波碎石术治疗小于2厘米的肾及上段输尿管结石的结石清除效果。
在一家大学附属三级护理医院进行的一项研究中，119例肾及上段输尿管结石患者在12个月内接受了体外冲击波碎石术。收集了患者人口统计学数据、结石特征、治疗过程及并发症的数据。治疗后每两周进行一次随访评估，持续两个月。
患者的平均年龄为39.78岁，平均结石大小为1.2厘米。右肾结石更为常见（61.3% [n = 76]）。并发症包括发热（19.3% [n = 23]）、肉眼血尿（24.3% [n = 29]）和石街形成（21.8% [n = 26]）。体外冲击波碎石术的成功率为81.5%（n = 97），18.5%（n = 22）的患者因结石破碎不完全或残留碎片>4毫米而需要手术干预。结石大小和密度对治疗成功起着重要作用。
尽管微创技术有所进步，但体外冲击波碎石术作为小于2厘米的肾及上段输尿管结石的非侵入性有效治疗选择，仍然具有重要意义。其成功取决于多种因素，包括结石部位、大小和成分。体外冲击波碎石术具有发病率低、住院时间短和患者依从性好等优点。石街形成等并发症可通过保守措施或辅助程序进行处理。虽然在某些情况下体外冲击波碎石术可能逐渐失宠，但其非侵入性本质和良好的治疗效果使其成为结石治疗手段中的一个有价值的选择。
