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KMID : 0371619950110020303
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Journal of Wonkwang Medical Science
1995 Volume.11 No. 2 p.303 ~ p.314
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Clinical Experience with EDAP LT-01 + Extracorporeal Shock Wave Lithotriptor; A Report of 1,816 Cases
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Choi Dong-Gyu
Seo Kie-Seok
Rim Joung-Sik
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Abstract
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Between February 8. 1990 and December 31. 1994, 1.816 renal units in 1.611 patients with urinary stones were treated with extracorporeal shock wave lithotripsy(ESWL) using the EDAP LT-01+ lithotriptor.The patients’ mean age was 44.3 years with the range of 16 months to 92 years. Sex ratio was 1.39:1 with 936(58.2%) male and 675(41.8%) female patients. Locations of the stones were kidney in 746(41.1%) including 39 cases of staghorn calculi, ureter in 1061(58.4%) and bladder in 9 cases(0.5%). And mean diameter of the stones was 13mm ranging from 2mm to 80mm. Average number of treatments, average treatment time per session and average total storage per patient were 4.0 sessions, 37.6 minutes and 134.4. respectively. Of the 1,816 cases. 141 cases(7.8%) complained of severe pain requiring intravenous or intramuscular analgesics. Success rates by stone size were 98.0%(1,069 cases/1,091 cases, storage/treatment number: 74.7/2.7) in less than 10㎜, 94.4%(453 cases/480 cases, 146.1/4.5) in 10㎜ to 19㎜. 73.4%(116 cases/158 cases, 242.4/7.1) in 20㎜ to 29㎜ and 60.9%(53 cases/87 cases. 402.6/11.2) in more than 30㎜. Success rates by stone location were 66.7%(6/9) in bladder stones. 66.7%(26/39) in staghorn calculi. 77.9%(60/77) in ureteropelvic junction(UPJ) stones. 93.1%(658/707) in renal stones, 94.8%(458/483) in upper ureteral stones and 96.4%(483/501) in lower ureteral stones. Success rate(when patients having stone particles less than 4mm in diameter without causing urinary tract obstrution, were considered to be treated successfully) was 93.l%( 1,691/1,816) and stone-free rates was 88.9% (1,615/1.816). Additional measures used were double-J stenting in 91 cases, percutaneous nephrostomy in 42 cases and push-up in 39 cases. Post-ESWL complications were persistent gross hematuria lasting more than three days in 29 cases, high fever(>38℃) in 38 cases and steinstrasse in 109 cases.We conclude that extracorporeal shock wave lithotripsy with EDAP LT-01 + lithotriptor is an effective treatment modality for urinary stone less than 2.0㎝ in diameter even though retreatment rate is high.
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