New stone formation: a comparison of extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy.
New stone formation: a comparison of extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy.
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DOI：
10.1016/s0022-5347(01)66127-5
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发表时间：
1996-05
期刊：
影响因子：
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通讯作者：
Lesley K. Carr;J. Honey;Michael A.S. Jewett;D. Ibañez;Michele R. Ryan;Claire Bombardier
中科院分区：
文献类型：
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作者：
Lesley K. Carr;J. Honey;Michael A.S. Jewett;D. Ibañez;Michele R. Ryan;Claire Bombardier
研究目的：理论上，体外冲击波碎石术（ESWL*）后结石复发率可能高于其他技术，因为残余结石碎片。Dornier Medical Systems，Inc.，材料与方法：我们记录了298名连续患者的所有新结石形成，这些患者在ESWL治疗小于2 cm的肾结石后最初达到无结石状态。并与62例非超声碎石经皮肾镜取石术的结果进行比较。在3个月时通过中心审查的腹部平片和肾脏断层扫描评估无结石状态。在12和24个月重复腹部平片检测recursion.Results22.2%的患者ESWL和4.2%经皮肾镜取石术后1年（p = 0.004），并在34.8%与22.6%，分别在2年（p = 0.190）。此外，更多的新的结石复发在较低和中间的calices相比，基线位置在ESWL组（卡方小于0.0001），这是没有观察到在经皮肾镜取石术group.ConclusionsOur数据支持的趋势更高的结石复发率在ESWL治疗的患者，这可能是由于微观沙粒迁移到依赖calices和作为一个新的结石形成的病灶。
PurposeThere is theoretical concern that stone recurrence rates may be higher following extracorporeal shock wave lithotripsy (ESWL*) compared to other techniques because of residual stone debris.*Dornier Medical Systems, Inc., Marietta, Georgia.Materials and MethodsWe documented all new stone formations in 298 consecutive patients who initially achieved a stone-free status following ESWL for renal calculi less than 2 cm. in largest dimension, and compared the findings to those of 62 patients treated with percutaneous nephrolithotomy without ultrasonic fragmentation. Stone-free status was assessed by a centrally reviewed plain abdominal film and renal tomograms at 3 months. A plain abdominal film was repeated at 12 and 24 months to detect recurrence.ResultsNew stones formed in 22.2 percent of patients after ESWL and 4.2 percent after percutaneous nephrolithotomy at 1 year (p = 0.004), and in 34.8 percent versus 22.6 percent, respectively, at 2 years (p = 0.190). Furthermore, more new stones recurred in the lower and mid calices compared to baseline location in the ESWL group (chi-square less than 0.0001), which was not observed in the percutaneous nephrolithotomy group.ConclusionsOur data support a trend toward higher stone recurrence rates in ESWL treated patients, which may be due to microscopic sand particles migrating to dependent calices and acting as a nidus for new stone formation.