Denstedt J D, Razvi H A, Fox M J
Division of Urology, University of Western Ontario, London, Canada.
J Endourol. 1995 Dec;9(6):453-5. doi: 10.1089/end.1995.9.453.
Electrohydraulic lithotripsy (EHL) of ureteral calculi has proved to be an effective and relatively inexpensive method of intracorporeal lithotripsy. However, the potential for significant ureteral injury is an everpresent concern with conventional EHL. The electromechanical impactor (EMI), an innovative modification of a standard EHL probe, has been shown in initial investigations to be capable of fragmenting urinary calculi with a greater margin of safety. Herein, we describe our preliminary experience with this new device in 23 patients with ureteral calculi. In nine patients selected to undergo EMI treatment, the device could not be employed because of either inability to access the stone with the large endoscope required (six cases) or device malfunction (three cases). Among the patients in whom the EMI was used, five required an additional modality of intracorporeal lithotripsy to complete stone fragmentation. In the remaining nine patients, stone fragmentation was achieved with the EMI as the sole modality of lithotripsy, for an overall success rate of 39% (9/23). There were no complications directly related to use of the EMI as noted endoscopically or on postoperative imaging. The EMI appears to be a safe device for intracorporeal lithotripsy. Its application to a large population of patients with ureteral stones may be limited by the probe size (5F), which precludes its use with the smaller rigid and flexible ureteroscopes.
输尿管结石的电液压碎石术（EHL）已被证明是一种有效且相对廉价的体内碎石方法。然而，传统EHL存在导致严重输尿管损伤的潜在风险，这一直是人们关注的问题。机电冲击器（EMI）是标准EHL探头的一种创新性改进，初步研究表明它能够在更高的安全边际下破碎尿路结石。在此，我们描述了我们在23例输尿管结石患者中使用这种新设备的初步经验。在选择接受EMI治疗的9例患者中，由于无法使用所需的大型内窥镜接近结石（6例）或设备故障（3例），该设备无法使用。在使用EMI的患者中，5例需要额外的体内碎石方式来完成结石破碎。在其余9例患者中，仅使用EMI作为碎石方式实现了结石破碎，总体成功率为39%（9/23）。在内窥镜检查或术后影像学检查中，未发现与使用EMI直接相关的并发症。EMI似乎是一种安全的体内碎石设备。其应用于大量输尿管结石患者可能会受到探头尺寸（5F）的限制，这使得它无法与较小的硬性和软性输尿管镜配合使用。
