Predictive factors of the success of EDAP LTO2 (R) extracorporeal shock-wave lithotripsy of lower caliceal stones

Citation
M. Nouri et al., Predictive factors of the success of EDAP LTO2 (R) extracorporeal shock-wave lithotripsy of lower caliceal stones, PROG UROL, 10(4), 2000, pp. 529-536
Citations number
58
Language
FRANCESE
art.tipo
Article
Categorie Soggetti
Urology & Nephrology
Journal title
PROGRES EN UROLOGIE
ISSN journal
1166-7087 → ACNP
Volume
10
Issue
4
Year of publication
2000
Pages
529 - 536
Database
ISI
SICI code
1166-7087(200009)10:4<529:PFOTSO>2.0.ZU;2-I
Abstract
Objective: to determine the predictive factors of success of extracorporeal shock-wave lithotripsy (ESWL) for lower caliceal stones. Patients and Methods: The case files of 100 patients with a single stone in the lower pole of the kidney, ranging in size from 6 to 25 mm, treated by EDAP LTO2 extracorporeal lithotripsy between 1994 and 1997 were studied Pre treatment intravenous urography was reviewed to assess the characteristics of the stone, to measure the pyelocaliceal angle and to study the anatomy o f the lower pole of the kidney. Results: The overall stone-free rate at 3 months was 57%. The success rate was 67.18% for stones smaller them 1 cm and 38.88% for stones larger than 1 cm. Stones denser than bone rc ere successfully treated in 45.5% of cases, those less dense than bone were successfully treated in 71.11% of cases. T he success rate was 86.04% when the pyelocaliceal angle was greater than 90 degrees and 35.08% when this angle was less than 90 degrees. The stone-fre e rate was 75% when the caliceal stalk was less than 3 cm and 37.5% when th e stalk was greater than 3 cm. Conclusion: In this series, the size of the stone, ifs density the pyelocal iceal angle and the length of the caliceal stalk were predictive elements o f the success of ESWL for lower caliceal stones. The pyelocaliceal angle wa s the most significant factor A very dense stone on the plain abdominal fil m with a diameter of 1 cm or more and presenting unfavourable anatomical fa ctors should be treated by percutaneous nephrolithotomy as the first-line p rocedure.