Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Impact of power index, hydroureteronephrosis, stone size, and composition on the efficacy of in situ boosted ESWL for primary proximal ureteral calculi
Autore:
Singh, I; Gupta, NP; Hemal, AK; Dogra, PN; Ansari, MS; Seth, A; Aron, M;
Indirizzi:
All India Inst Med Sci, Dept Urol, New Delhi 110029, India All India Inst Med Sci New Delhi India 110029 l, New Delhi 110029, India
Titolo Testata:
UROLOGY
fascicolo: 1, volume: 58, anno: 2001,
pagine: 16 - 22
SICI:
0090-4295(200107)58:1<16:IOPIHS>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
SHOCK-WAVE LITHOTRIPSY; IN-SITU; TREATMENT OPTIONS; NATURAL-HISTORY; MANAGEMENT; TRIAL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Gupta, NP All India Inst Med Sci, Dept Urol, New Delhi 110029, India All India Inst Med Sci New Delhi India 110029 hi 110029, India
Citazione:
I. Singh et al., "Impact of power index, hydroureteronephrosis, stone size, and composition on the efficacy of in situ boosted ESWL for primary proximal ureteral calculi", UROLOGY, 58(1), 2001, pp. 16-22

Abstract

Objectives. The efficacy, safety, feasibility, and outcome of in situ treatment applied to select proximal ureteral calculi was assessed and analyzedwith a view to avoiding auxiliary interventions and providing high clearance rates in the shortest possible time. We studied the impact of several clinically important variables, including power index, degree of hydroureteronephrosis (HDUN), stone size, and composition on the efficacy of sequentialin situ boosted extracorporeal shock wave lithotripsy (ESWL) in a select group. The power index requirement for the in situ boosted protocol and the impact of the stone size/composition, degree of HDUN, and clearance rates were also analyzed. Methods. An in situ (no instrumentation) boosted protocol was applied to 130 primary unimpacted proximal ureteral calculi with no prior intervention. A typical session with the Siemens Lithostar Plus comprised 3000 shock waves, in installments of 500, deployed at a power setting of 1 to 4 kV with agradual stepwise escalation. Sequential boosted additional sessions of ESWL were administered on days 2, 7, and 14, tailored to the degree of fragmentation, clearance status, and amount of residual stone bulk. Several parameters (shock waves, kilovolts used, fluoroscopy time, number of sessions, stone size, composition, fragmentation, clearance, and HDUN) were recorded and the results analyzed statistically. Results. The results were excellent in 83.8%, with a mean duration to complete clearance of 11.3 days. In situ ESWL failed in 7.69%, and the auxiliary intervention rate was 10.7%. Pre-ESWL HDUN was present in 78.3%, the meanpower index was 184.6/session/case, and the average stone burden was 8.9 mm(2). Calcium oxalate monohydrate was the most common stone (56%). Renal colic was the most common side effect observed. The power index, fragmentation at the first session, and stone size were found to be the most favorable significant variables affecting stone clearance. The degree of HDUN, numberof sessions, and stone composition did not significantly impact the clearance rates. Conclusions. In situ boosted ESWL should be the first-line therapeutic modality in select unimpacted primary proximal ureteral stones. UROLOGY 58: 16-22, 2001. (C) 2001, Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 19:06:43