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KMID : 0381219880200010013
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Journal of RIMSK
1988 Volume.20 No. 1 p.13 ~ p.19
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Effects of Extracorporeal Shock Wave Lithotripsy on the Kidney and Perinephric Tissues
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Abstract
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The CT scans in 130 patients before and after extracorporeal shock wave lithotripsy for the treatment of renal and proximal ureteral calculi were analyzed to study the effects of piezoelectric pulsed shock wave on the kidney and perinephric soft tissues. The equipment used for a ESWL was second generation piezoelectric pulsed lithotripter LT-01(EDAP, France). Post-ESWL CT scans demonstrated statistically significant mean increase in renal size(13% in short axis and 5% in long axis) at the level of the stone. Diffuse swelling was seen in eighty three(64%) of the treated 130 kidneys and focal swelling in four(3%) patients. Nine patients with post-ESWL hydronephrosis and five patients with subcapsular hematoma revealed more than average increase in renal size(18% in short axis and 9% in long axis) at the level of the stone. Perinephric soft tissue stranding with associated blurring of renal capsule and thickening of Gerota´s fascia were seen in seventy nine(61 %) patients. Crescentic shaped high density subcapsular hematoma was found in five(4%) patients (two large, three small) and parenchymal hematoma in four(3%) patients. Hemorrhage into a preexisting simple cyst was seen in one patient.
Our results show that ESWL performed with piezoelectric pulsed shock wave lithotripter appears to be associated with a low incidence of serious complications, in spite of some morphologic changes of the kidney and perinephric tissues seen in most patients.
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