2019, Number 6
Efficacy of kidney stone management through extracorporeal shock wave lithotripsy at a tertiary care center in Mexico City
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ABSTRACTBackground: The incidence of urinary lithiasis in children is low (~3%). Extracorporeal shockwave lithotripsy is a first-line therapeutic alternative for kidney stones smaller than 20 mm. However, it has the disadvantage of a variable success rate (after the first session it varies from 60 to 90%) that is directly associated with stone size, density, and composition. The predictive factors for success of the procedure are stone load, lower infundibular length, and the infundibulopelvic angle (› 45o).
Objective: To determine the overall efficiency of extracorporeal shock wave lithotripsy as treatment for kidney stones in the pediatric population at the Hospital General de México.
Material and methods: A cross-sectional, analytic, retrospective study included 45 case records of pediatric patients that underwent extracorporeal shock wave lithotripsy as kidney stone management. The inclusion criteria were patient age from 1 to 18 years, stone diameter 20 mm, and stone located in the kidney; the exclusion criteria were patients › 18 years of age, stone diameter › 20 mm, stone located outside the kidney, obstruction, pregnancy, or blood dyscrasia; and the elimination criteria were patients with no radiologic follow-up (1 month).
Results: Kidney stones were resolved in 28 patients, resulting in a success rate of 62.2% (95% CI: 47.5-77.0). The factors associated with therapeutic failure were stone size (p=0.03) and stone location in the kidney unit (p= 0.03).
Conclusions: Our study results were similar to those reported in the literature for the management of kidney stones in the pediatric population, with respect to safety, efficacy, and stone-free status.
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Srisubat A, Potisat S, Lojanapiwat B, Setthawong V, Laopaiboon M. Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones. Cochrane Database Syst Rev. 2014 Nov 24;(11):CD007044. doi: https://doi. org/10.1002/14651858.CD007044.pub3