Improvement of stone comminution by slow delivery rate of shock waves in extracorporeal lithotripsy
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概要
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Blackwell Publishing, Kato, Yuji ; Yamaguchi, Satoshi ; Hori, Junichi ; Okuyama, Mitsuhiko ; Kakizaki, Hidehiro, International Journal of Urology, 13(12), 2006, 1461-1465AIM: The aim of this study was to investigate the effect of delivery rate of shockwaves (SW) on stone comminution and treatment outcomes in patients with renal and ureteral stones. METHODS: Patients with radio-opaque stones in the upper urinary tract that were treated by extracorporeal shock wave lithotripsy (ESWL) were divided into two groups according to delivery rate (120 or 60 SW/min). The effective fragmentation after one ESWL session and treatment success at 3 months after ESWL was compared between the two groups. RESULTS: Of 134 patients (84 men and 50 women), 68 patients were treated at a fast rate and 66 were treated at a slow rate. Thirty and 38 patients in the fast rate group and 28 and 38 in the slow rate group had renal and ureteral stones, respectively. After one ESWL session, effective fragmentation was noted more often in the slow group (65.2%) than the fast group (47.1%) (P = 0.035), particularly for smaller stones (stone area <100 mm(2)) (P = 0.005) and renal stones (p = 0.005). However, there was no significant difference in treatment success at 3 months after ESWL between the two groups. In univariate logistic regression analysis, slow SW rate and smaller stones were significant factors for effective fragmentation after one ESWL session. In multivariate analysis, slow SW rate and smaller stones were also independent factors. CONCLUSIONS: Slow SW rate contributed to better stone comminution than fast rate, particularly for small stones and renal stones. ESWL treatment at a slow SW rate is recommended to obtain efficient stone fragmentation.
- 2006-12-01
著者
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YAMAGUCHI SATOSHI
Department of Surgery, Nagasaki Prefectural Shimabara Hospital
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KAKIZAKI HIDEHIRO
Department of Urology, Hokkaido University Graduate School of Medicine
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KATO Yuji
Department of Biotechnology and Biomaterial Chemistry, Graduate School of Engineering, Nagoya Univer
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OKUYAMA MITSUHIKO
Department of Urology, Asahikawa Medical College
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Hori Junichi
Department Of Physics Hokkaido University
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Kakizaki Hidehiro
Department Of Urology Asahikawa Medical College
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Hori Junichi
Department Of Urology Asahikawa Medical College
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Yamaguchi S
Department Of Biology Faculty Of Science Kanazawa University
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Okuyama Mitsuhiko
Department Of Urology Asahikawa Medical College
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Kato Yuji
Department Of Urology Asahikawa Medical College
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Yamaguchi Satoshi
Department Of Applied Chemistry Graduate School Of Engineering Kyushu University
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Kato Yuji
Department Of Applied Chemistry Faculty Of Engineering Muroran Institute Of Technology
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Yamaguchi Satoshi
Department Of Agricultural Chemistry Faculty Of Agriculture Kyushu University
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Kakizaki Hidehiro
Department Of Renal And Genitourinary Surgery Hokkaido University Graduate School Of Medicine
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Kato Yuji
Department Of Agricultural Chemistry Faculty Of Agriculture Tohoku University
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加藤 祐司
Department of Urology, Asahikawa Medical College
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Hori J
Department of Urology, Asahikawa Medical College
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Okuyama M
Department of Urology, Asahikawa Medical College
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Kakizaki H
Department of Urology, Asahikawa Medical College
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KATO YUJI
Department of Urology, Asahikawa Medical College
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