Treatment of mid- and lower ureteric calculi, extracorporeal shock-wave lithotripsy vs laser ureteroscopy. A comparison of costs, morbidity and effectiveness
| Autor: | H.P. Beerlage, J.J.M.H.C. de la Rosette, Ad J.M. Hendrikx, A.F. Bierkens, A.J. Arends, Frans M.J. Debruyne, G.N.M. Stultiens |
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| Rok vydání: | 1998 |
| Předmět: |
Male
medicine.medical_specialty Ureteral Calculi Adolescent Urology medicine.medical_treatment Treatment duration Lithotripsy Toepassingen van biomedische technieken in de urologie Extracorporeal Application of BioMedical Engineering in Urology Ureter Recurrence medicine Ureteroscopy Humans Hospital Costs Aged Retrospective Studies medicine.diagnostic_test business.industry Retrospective cohort study Length of Stay Middle Aged Laser lithotripsy Extracorporeal shock wave lithotripsy Surgery medicine.anatomical_structure Treatment Outcome Costs and Cost Analysis Female Laser Therapy business |
| Zdroj: | BJU International, 81, pp. 31-35 BJU International, 81, 31-35 |
| ISSN: | 1464-4096 |
| Popis: | Objectives To determine the efficacy and costs of extracorporeal shock-wave lithotripsy (ESWL) compared with ureteroscopy (URS) in the treatment of mid- and lower ureteric calculi. Patients and methods The records of patients treated primarily by ESWL and URS were analysed retrospectively. Treatment with ESWL included 63 patients (42 men and 21 women, mean age 52 years, range 23–78, 19 mid- and 44 lower ureteric calculi). All patients received 4000 shock waves at a mean energy setting of 18.1 kV. URS was used in 105 patients, with a 7.2 F miniscope or the 7.1 F flexible scope. Stones were fragmented with a pulsed-dye laser lithotripter at 504 nm and a power of up to 130 mJ (mean 53 mJ) using a 200 or 320 μm fibre. All ureteroscopies were performed with the patient under general (n=17) or spinal (n=87) anaesthesia in a mean treatment duration of 34 min. Stones were located in the mid-ureter in 24 patients and in the lower ureter in 80. The outcome was assessed by stone-free rates, re-treatment rates, time to become stone-free, complications and costs. Results ESWL for mid- and lower ureteric calculi resulted in a success rate of 90% and 81%, respectively, compared with 96% and 99% for URS. However, patients treated with URS were stone-free within 2 days, whereas patients in the ESWL group required up to 4 months. The best results for ESWL were achieved with stones of |
| Databáze: | OpenAIRE |
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