Hernández-Alcaraz D, Molina-Díaz P, Caballero-Cobos R

Language: Spanish
References: 10
Page: 1-7
PDF size: 225.25 Kb.

ABSTRACT

Objective: To evaluate the effectiveness and complications of treatment with extracorporeal shock wave lithotripsy (ESWL) for staghorn stones.
Design: A retrospective observational study on staghorn stones treated with ESWL at the Hospital Regional Universitario de Málaga, between 1990 and 2010.
Results: The study included 157 patients (136 women and 21 men) that underwent ESWL for staghorn stones. Mean number of sessions for fragmentation was 3.39± 1.94, mean number of waves was 10,066.67±6,182.96, mean intensity was 16.24±12.37, mean accumulated energy was 402.69±182.07, and mean resolution time was 7.59±7.97 months. Of the patients analyzed, 106 were stone-free and 51 had small residual fragments. Only 12 patients had stone recurrence. The mortality rate was 0%. Ten percent of the patients had type IIIb Clavien-Dindo complications, 18% had type IIIa, and 3.31% had type II. The effectiveness quotient (Clayman et al.) was 0.49, if needing more than one session was considered retreatment, and 0.71, if all sessions were considered a single treatment.
Study limitations: Given the retrospective, observational study design, the conclusions were relative, due to the heterogeneity between patients regarding urinary tract morphology, stone size, and stone composition.
Originality or value: ESWL in patients with multiple comorbidities is an alternative to surgery.
Conclusions: Even though ESWL is not the treatment of choice for staghorn stones, it is a valid option in selected cases, depending on availability at the center and/or experience of the urologist

REFERENCES

1. Cano-Castiñeira R, Carrasco-Valiente J, Pérula-de-Torres LA, Jiménez-García C, Olaya- Caro I, Criado-Larumbe M, et al. Prevalencia de la litiasis renal en Andalucía: resultados del estudio PreLiRenA. Actas Urológicas Españolas. 2015;39(1):26–31. doi: 10.1016/j. acuro.2014.02.006

2. Türk C, Neisius A, Petrik A, Seitz C, Skolarikos A, Thomas K. EAU Guidelines of Urolithiasis. European Association of Urology; 2018.

3. Bhatia V, Biyani CS. A comparative study of cystolithotripsy and extracorporeal shock wave therapy for bladder stones. Int Urol Nephrol. 1994;26(1):26–31. doi: 10.1007/BF02768241

4. García-Galisteo E, Sánchez-Martínez N, Molina- Díaz P, López-Rueda B, Baena-González V. Tendencia en los tratamientos invasivos en la litiasis urinaria en un hospital de tercer nivel. Actas Urológicas Españolas. 2015;39(1):32–7. doi: 10.1016/j.acuro.2014.03.013

5. American Urological Association. Preminger y col. Neprolithiasis Clinical Guidelines. American Urological Association; 2005.

6. Lingeman J, Matlaga B, Evan A. Tratamiento quirúrgico de los cálculos en las vías urinarias superiores. In: Urología. 9o. Buenos Aires: Panamericana; 2008. p. 1431–507.

7. Goodwin WE, Casey WC. Percutaneous antegrade pyelography & translumbar needle nephrostomy in hydronephrosis. AMA Arch Surg. 1956;72(2):357–65. doi: 10.1001/ archsurg.1956.01270200173030

8. Fernström I, Johansson B. Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol. 1976;10(3):257–9. doi: 10.1080/21681805.1976.11882084

9. Arrabal Martín M, Gutiérrez Tejero F, Ocete Martín C, Esteban De Vera H, Miján Ortiz JL, Zuluaga Gómez A. Tratamiento de la litiasis coraliforme. Archivos Españoles de Urología. 2004;57(1):9–24.

10. Torrecilla C, Vicéns-Morton AJ, Meza IA, Colom S, Etcheverry B, Vila H, et al. Complicaciones de la nefrolitotomía percutánea en decúbito prono de acuerdo a la clasificación de Clavien-Dindo modificada. Actas Urológicas Españolas. 2015;39(3):169–74. doi: 10.1016/j. acuro.2014.07.006