Double J stent reduces the efficacy of extracorporeal shock wave lithotripsy in the treatment of lumbar ureteral stones
Double J stent reduces the efficacy of extracorporeal shock wave lithotripsy in the treatment of lumbar ureteral stones
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DOI：
10.5173/ceju.2013.03.art14
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发表时间：
2013-01-01
影响因子：
1.2
通讯作者：
Avery, Vincent R.
中科院分区：
文献类型：
--
作者：
Pettenati, Caroline;El Fegoun, Amine Benchikh;Avery, Vincent R.
导言。目的：探讨双J管置入对体外冲击波碎石术(ESWL)治疗腰部输尿管结石疗效的影响。在2007年1月至2012年2月期间，我们进行了一项回溯性队列研究。采用体外冲击波碎石术(ESWL)治疗腰段输尿管结石44例，随机分为两组：非支架组(27例)和支架组(17例)。治疗后1个月行腹部X线片或CT检查评价疗效。无结石患者和残留结石=4 mm的患者被认为是治愈的。结石平均直径8.2 mm/831HU，密度9.7 mm/986HU。两组在年龄、BMI、结石大小和密度、ESWL注射次数和强度方面具有可比性。1、2组成功率分别为81.5%和47.1%(P=0.017)。对于直径小于或等于8 mm的结石，两组之间没有差异(p=0.574)。对于8 mm的结石，第1组和第2组的成功率分别为76%和22.2%(P=0.030)。Logistic回归分析显示，当双J支架的结石直径为8 mm时，失败率更高(p=0.033)。双J管的存在影响ESWL治疗腰部输尿管结石的疗效。这种影响对于8 mm的石材来说非常显著。输尿管镜检查应被视为此类患者的一线治疗方法。
Introduction. We evaluated the effect of the presence of a double J stent on the efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of lumbar ureteral stones.Material and methods. Between January 2007 and February 2012, we performed a retrospective cohort study. Forty-four patients were treated by ESWL for lumbar ureteral stones and included into two groups for the analysis: group 1, non-stented (n = 27) and group 2, stented patients (n = 17). Treatment efficacy was evaluated by abdominal X-ray or CT-scan at 1 month. Stone-free patients and those with a residual stone = 4 mm were considered to be cured.Results. Mean stone size and density in groups 1 and 2 were 8.2mm/831HU, and 9.7 mm/986HU respectively. Both groups were comparable for age, BMI, stone size and density, number, and power of ESWL shots given. The success rates in groups 1 and 2 where 81.5% and 47.1%, respectively (p = 0.017). There was no difference between the groups for stones measuring 8 mm or less (p = 0.574). For stones > 8 mm, the success rates were respectively 76% and 22.2% for groups 1 and 2 (p = 0.030). Logistic regression analysis revealed a higher failure rate when a double J stent was associated with a stone > 8 mm (p = 0.033).Conclusions. The presence of a double J stent affects the efficacy of ESWL in the treatment of lumbar ureteral stones. This effect is significant for stones > 8 mm. Ureteroscopy should be considered as the first-line treatment in such patients.