当前位置： SCI文献检索 > JOURNAL OF ENDOUROLOGY期刊下所有文献 > A prospective randomized comparison between shockwave lithotripsy and semirigid ureteroscopy for upper ureteral stones

A prospective randomized comparison between shockwave lithotripsy and semirigid ureteroscopy for upper ureteral stones

Abstract：

BACKGROUND AND PURPOSE:The best management of upper ureteral calculi is undefined. We performed a prospective randomized comparison between semirigid ureteroscopy (URS) and shockwave lithotripsy (SWL) for upper ureteral stones <2 cm to evaluate safety and efficacy of both procedures. PATIENTS AND METHODS:Patients with a single radiopaque upper ureteral stone <2 cm undergoing treatment between January 2010 and May 2011 in our department were included. Randomization was performed into two groups-group A: SWL performed as an outpatient procedure using an electromagnetic lithotripter (Dornier Compact Delta); group B: URS performed using an 6/7.5F semirigid ureteroscope with holmium laser intracorporeal lithotripsy. Statistical analysis was performed regarding demographic profile, success rates, retreatment rates, auxiliary procedures, and complications. RESULTS:There were 90 patients enrolled in each group. Mean stone size: 12.3 mm in group A vs 12.5 mm in group B (P=0.52). The overall 3-month stone-free rate was (74/90) 82.2% for group A vs (78/90) 86.6% for group B (P=0.34). For stone size <10 mm, 3-month stone-free rates were (45/53) 84.9% for group A vs (43/49) 87.7% for group B (P=0.32). For 10 to 20 mm stones, 3-month stone-free rates were (29/37) 78.4% for group A vs (35/41) 85.4% for group B (P=0.12).The re-treatment rate was significantly greater in group A than group B (61.1% vs 1.1%, respectively; P<0.001). The auxiliary procedure rate was comparable in both groups (21.1% vs 17.7%; P=0.45). The complication rate was 6.6% in group A vs 11.1% in group B (P=0.21). CONCLUSIONS:Both SWL and semirigid URS are safe and highly efficacious for treating patients with proximal ureteral stones <20 mm. For stones <10 mm, SWL was safer, less invasive, and of comparable efficacy with URS. For stones between 10 and 20 mm, however, URS was more effective, with a lesser re-treatment rate.

journal_name

J Endourol

journal_title

Journal of endourology

authors

Kumar A,Nanda B,Kumar N,Kumar R,Vasudeva P,Mohanty NK

doi

10.1089/end.2012.0493

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

47-51

issue

eissn

0892-7790

issn

1557-900X

journal_volume

pub_type

杂志文章,随机对照试验

在线工具

A prospective randomized comparison between shockwave lithotripsy and semirigid ureteroscopy for upper ureteral stones