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Titolo:
Preliminary results of a randomized controlled trial of prophylactic shockwave lithotripsy for small asymptomatic renal calyceal stones
Autore:
Keeley, FX; Tilling, K; Elves, A; Menezes, P; Wills, M; Rao, N; Feneley, R;
Indirizzi:
Southmead Gen Hosp, Bristol Urol Inst, Bristol BS10 5NB, Avon, England Southmead Gen Hosp Bristol Avon England BS10 5NB BS10 5NB, Avon, England Univ London Kings Coll, Dept Publ Hlth Sci, London WC2R 2LS, England Univ London Kings Coll London England WC2R 2LS London WC2R 2LS, England Withington Hosp, Manchester M20 8LR, Lancs, England Withington Hosp Manchester Lancs England M20 8LR M20 8LR, Lancs, England
Titolo Testata:
BJU INTERNATIONAL
fascicolo: 1, volume: 87, anno: 2001,
pagine: 1 - 8
SICI:
1464-4096(200101)87:1<1:PROARC>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
PERCUTANEOUS NEPHROLITHOTOMY; FOLLOW-UP; CALCULI; FRAGMENTS; EFFICACY; KIDNEY;
Keywords:
lithotripsy; ESWL; asymptomatic; calyceal calculi; conservative treatment; outcome;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Keeley, FX Southmead Gen Hosp, Bristol Urol Inst, Bristol BS10 5NB, Avon, England Southmead Gen Hosp Bristol Avon England BS10 5NB Avon, England
Citazione:
F.X. Keeley et al., "Preliminary results of a randomized controlled trial of prophylactic shockwave lithotripsy for small asymptomatic renal calyceal stones", BJU INT, 87(1), 2001, pp. 1-8

Abstract

Objective To report a prospective, randomized study to determine whether prophylactic extracorporeal shockwave lithotripsy (ESWL) is justified as a treatment for small, asymptomatic calyceal stones. Patients and methods The study included 228 patients with small (<15 mm total diameter) asymptomatic calyceal stones; 113 patients were randomized toundergo ESWL and 115 to the control group who were kept under observation. Outcome measurements included the stone-free rate, requirement for additional treatment, symptoms, quality of life and renal function. Results In all, 200 patients had at least one annual follow-up; all outcome measurements reported were those at the most recent follow-up (mean 2.2 years, range 1-5). In the ESWL group 28 patients (28%) were stone-free, compared with 16 (17%) in the observation group (odds ratio 1.95, 95% confidence interval, CI, 0.97-3.89, P = 0.06), Additional treatment in the form of analgesics, antibiotics, ESWL, stent insertion and ureteroscopy, was required in 21 (21%) patients in the observation group and 15 (15%) in the ESWL group (odds ratio 0.66, 95% CI 0.32-1.37, P = 0.27), Ten patients in the observation group required invasive procedures, vs none in the ESWL group, There was no evidence of differences in the symptoms, quality of life or renal function tests between the arms of the trial at the final follow-up. Conclusions Prophylactic ESWL for small asymptomatic renal calyceal stonesdoes not appear to offer any advantage to patients in terms of stone-free rate, quality of life, renal function, symptoms or hospital admissions. However, a policy of observation is associated with a greater risk of requiring more invasive procedures, A longer follow-up is required to assess the validity of these preliminary findings.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 19:28:00