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[PMID]:28741596
[Au] Autor:Allen SP; Vlaisavljevich E; Shi J; Hernandez-Garcia L; Cain CA; Xu Z; Hall TL
[Ad] Endereço:Department of Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd. Ann Arbor, MI 48109, United States of America.
[Ti] Título:The response of MRI contrast parameters in in vitro tissues and tissue mimicking phantoms to fractionation by histotripsy.
[So] Source:Phys Med Biol;62(17):7167-7180, 2017 Aug 18.
[Is] ISSN:1361-6560
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Histotripsy is a non-invasive, focused ultrasound lesioning technique that can ablate precise volumes of soft tissue using a novel mechanical fractionation mechanism. Previous research suggests that magnetic resonance imaging (MRI) may be a sensitive image-based feedback mechanism for histotripsy. However, there are insufficient data to form some unified understanding of the response of the MR contrast mechanisms in tissues to histotripsy. In this paper, we investigate the response of the MR contrast parameters R1, R2, and the apparent diffusion coefficient (ADC) to various treatment levels of histotripsy in in vitro porcine liver, kidney, muscle, and blood clot as well in formulations of bovine red blood cells suspended in agar gel. We also make a histological analysis of histotripsy lesions in porcine liver. We find that R2 and the ADC are both sensitive to ablation in all materials tested here, and the degree of response varies with tissue type. Correspondingly, under histologic analysis, the porcine liver exhibited various levels of mechanical disruption and necrotic debris that are characteristic of histotripsy. While the area of intact red blood cells and nuclei found within these lesions both decreased with increasing amounts of treatment, the area of red blood cells decreased much more rapidly than the area of intact nuclei. Additionally, the decrease in area of intact red blood cells saturated at the same treatment levels at which the response of the R2 saturated while the area of intact nuclei appeared to vary linearly with the response of the ADC.
[Mh] Termos MeSH primário: Biomimética
Ablação por Ultrassom Focalizado de Alta Intensidade/métodos
Rim/cirurgia
Fígado/cirurgia
Imagem por Ressonância Magnética/métodos
Imagens de Fantasmas
[Mh] Termos MeSH secundário: Animais
Bovinos
Meios de Contraste
Fracionamento de Dose
Técnicas In Vitro
Litotripsia
Suínos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1088/1361-6560/aa81ed


  2 / 9119 MEDLINE  
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[PMID]:29320618
[Au] Autor:Savic S; Vukotic V; Lazic M; Savic N
[Ti] Título:Stenting versus non-stenting following uncomplicated ureteroscopic lithotripsy: Comparsion and evaluation of symptoms.
[So] Source:Vojnosanit Pregl;73(9):850-6, 2016 Sep.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Background/Aim: Currently, ureterorenoscopic (URS) stone fragmentation and removal is the treatment of choice for managing ureteral stones, especially mid and distal ones and is advocated as initial management of ureteric stones. The aim of this work was to evaluate the symptoms, necessity, potential benefits and adverse effects of ureteral stent placement after uncomplicated ureteroscopic lithotripsy. Methods: This retrospective-prospective study evaluated a total of 125 patients who had underwent ureteroscopic lithotripsy (URSL). The patients were divided into two groups: stented (59 patients) and unstented (controls, 66 patients). The outcomes measured and compared between the two groups included: stone free rate, postoperative patient pain validated by scale, lower urinary tract symptoms (LUTS), the need for unplanned hospital care, stent related complications, and functional recovery in the form return to normal physical activities. Results: A successful outcome, defined as being stonefree after 12 weeks, was achieved in all 125 (100%) patients. The stone-free rate showed no significant differences between the two groups. LUTS was frequent complaint in the stented group, with statistically significant difference in the domain of frequency/urgency (p = 0.0314). There was a statistically significant difference between the groups in the mean operative time and mean hospitalization time, mean pain visual analog scale (VAS) score and in the use of nonnarcotic analgesic. On the day of the surgery and until postoperative day 3 (POD 3) and postoperative day 5 (POD 5), the pain score was much higher among stented patients than among the controls (p = 0.0001) and non-narcotic analgesic use (p = 0.001) was frequently required in the stented group. Conclusion: Routine placement of ureteral stent after URSL is not mandatory and may be associated with stent side effects. Uncomplicated URSL is safe without stent placement after the treatment.
[Mh] Termos MeSH primário: Litotripsia/instrumentação
Stents
Cálculos Ureterais/cirurgia
Ureteroscopia/instrumentação
[Mh] Termos MeSH secundário: Adulto
Idoso
Analgésicos não Entorpecentes/uso terapêutico
Intervalo Livre de Doença
Feminino
Seres Humanos
Tempo de Internação
Litotripsia/efeitos adversos
Masculino
Meia-Idade
Duração da Cirurgia
Dor Pós-Operatória/tratamento farmacológico
Dor Pós-Operatória/etiologia
Estudos Prospectivos
Desenho de Prótese
Estudos Retrospectivos
Fatores de Tempo
Resultado do Tratamento
Cálculos Ureterais/diagnóstico
Ureteroscopia/efeitos adversos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Non-Narcotic)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150525071S


  3 / 9119 MEDLINE  
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[PMID]:28968428
[Au] Autor:Wozniak P; Kontek B; Rózanski W; Olas B
[Ad] Endereço:2nd Department of Urology, Medical University of Lódz, Pabianicka 62, Lódz, Poland.
[Ti] Título:Evaluation of hemostasis parameters and the role of the oxidative damage to plasma proteins in the modulation of hemostasis in patients with nephrolithiasis before and after extracorporeal shock wave lithotripsy.
[So] Source:PLoS One;12(10):e0185157, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Extracorporeal shock wave lithotripsy (ESWL) is a commonly-used method in urology, which may modulate hemostasis and may induce lipid peroxidation in patients with nephrolithiasis. However, previous studies only examine changes occurring in patients 30-240 min after ESWL. The main aim of the present study was to determine whether oxidative stress may modulate the hemostatic activity of plasma in patients with nephrolithiasis before ESWL and the day after treatment ESWL. This will be performed by measuring selected parameters of hemostasis in these patients, both before ESWL and the following day, and assessing the level of oxidative damage to plasma proteins in these patients by measuring two biomarkers. METHODS: Twelve patients with nephrolithiasis and 10 healthy participants were included. The following parameters of hemostasis were measured: the activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) of plasma, the level of fibrinogen, the level of D-dimer and blood platelet count. In addition, two selected biomarkers of oxidative stress were measured: protein carbonylation level and the number of protein thiol groups. RESULTS: No difference was observed between patients with nephrolithiasis before and after ESWL and healthy controls with regard to PT, TT or APTT. Fibrinogen concentration and blood platelet count were lower in the nephrolithiasis patients in the period after ESWL than before ESWL. The nephrolithiasis patients demonstrated elevated D-dimer concentration after ESWL. However, although oxidative damage was observed in the plasma proteins in the nephrolithiasis patients, this was not influenced by ESWL. CONCLUSION: Oxidative stress may induce changes of hemostasis in patients with nephrolithiasis, both before and after ESWL. In addition, changes of hemostasis parameters such as fibrinogen, blood platelet count and D-dimer level can be observed in these patients, especially after ESWL, and this may suggest that ESWL modulates hemostasis. By having a better understanding of the influence of ESWL on hemostasis, this could lead to modifying patient care for those patients at increased risk of bleeding.
[Mh] Termos MeSH primário: Proteínas Sanguíneas/metabolismo
Hemostasia
Cálculos Renais/terapia
Litotripsia/métodos
Estresse Oxidativo
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Cálculos Renais/metabolismo
Cálculos Renais/fisiopatologia
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Blood Proteins)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185157


  4 / 9119 MEDLINE  
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[PMID]:28952703
[Au] Autor:Mamedov EA; Dutov VV; Bazaev VV
[Ad] Endereço:Institute, Moscow, Russia.
[Ti] Título:[Complications of contact ureteral lithotripsy].
[So] Source:Urologiia;(4):113-119, 2017 Sep.
[Is] ISSN:1728-2985
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:Shows the current real time terminology and variants of systematization and grading of complications of contact ureteral lithotripsy (CULT). Research papers related to complications of CULT published over the last three decades were analyzed. Currently there is no clear terminology, classification, systematization and grading of CULT complications. The terms used are deficient because they do not adequately characterize specific complications of CULT. For example, some researchers define a complete ureteral avulsion as a defect at two levels, but others interpret it as a defect of the ureter at only one level. And the use of such terms as extravasation of the contrast media and/or migration of the stone outside of the ureter is groundless because these complications occur only after the perforation of the ureter wall. Therefore, these conditions are complications not of CULT but of the ureteral wall perforation. Presently, the classical classification of CULT cannot be adequately used, since it is low-structured. Universal instruments (PULS, Satava, Clavien-Dindo) have low specificity and sensitivity to CULT complications and limited possibilities of their application. Both developers of different scales of systematization of CULT complications (PULS; Satava; Clavien-Dindo) and EAU consider further international randomized studies warranted for their greater integration and adaptation.
[Mh] Termos MeSH primário: Complicações Pós-Operatórias/etiologia
Cálculos Ureterais/terapia
[Mh] Termos MeSH secundário: Seres Humanos
Litotripsia/efeitos adversos
Complicações Pós-Operatórias/classificação
Complicações Pós-Operatórias/terapia
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE


  5 / 9119 MEDLINE  
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[PMID]:28931028
[Au] Autor:Chiang BJ; Liao CH; Lin YH
[Ad] Endereço:Department of Life Science, National Taiwan Normal University, Taipei, Taiwan.
[Ti] Título:The efficacy of extracorporeal shockwave lithotripsy for symptomatic ureteral stones: Predictors of treatment failure without the assistance of computed tomography.
[So] Source:PLoS One;12(9):e0184855, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Non-contrast computed tomography (NCCT) is not always performed clinically if the diagnosis of ureteral calculi has been confirmed using other radiographic imaging modalities. The aim of this study was to identify predictors of successful extracorporeal shockwave lithotripsy (ESWL) without assistance of NCCT. METHODS: We retrospectively reviewed the medical records of patients with symptomatic solitary ureteral stones who underwent ESWL between November 2015 and January 2016. Abdominal plain radiography or intravenous urography were performed before ESWL for localization. The exclusion criteria were repeated sessions of ESWL for the target stone and congenital genitourinary tract anomalies. The demographic characteristics, clinical history, medical charges, or imaging features of the stones were recorded. Successful treatment was defined as no fragments detected on radiography or ultrasonography in 4 weeks. For radiolucent calculi, successful treatment was regarded as cases without hydronephrosis, symptoms, or hematuria. Patients experiencing intractable pain and undergoing subsequent auxiliary surgeries were regarded as having ESWL treatment failure. RESULTS: Age (odds ratio [OR], 1.042; 95% confidence interval [CI], 1.007-1.078), history of ipsilateral renal or ureteral calculi episodes (OR, 2.669; 95% CI, 1.281-5.687), stone burden (OR, 3.499; 95% CI, 1.284-9.530), and radiopaque stone (OR, 2.351; 95% CI, 1.049-5.267) were significant predictors of ESWL failure in all patients. CONCLUSIONS: For treating symptomatic ureteral stones, those with smaller size, radiolucency, and without a history of ipsilateral renal or ureteral calculi could be considered for first-line therapy with ESWL.
[Mh] Termos MeSH primário: Litotripsia/efeitos adversos
Dor Intratável/diagnóstico
Dor Intratável/etiologia
Cálculos Ureterais/complicações
Cálculos Ureterais/terapia
[Mh] Termos MeSH secundário: Feminino
Hematúria
Seres Humanos
Hidronefrose
Masculino
Meia-Idade
Radiografia Abdominal
Estudos Retrospectivos
Tomografia Computadorizada por Raios X
Falha de Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170921
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184855


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[PMID]:28858120
[Au] Autor:Li W; Zhang SX; Yang Q; Li BL; Meng QG; Guo ZG
[Ad] Endereço:Department of Medical Science Institute of Harbin, First Hospital of Harbin City, Harbin Medical University, Harbin, China.
[Ti] Título:Effect of extracorporeal shock-wave therapy for treating patients with chronic rotator cuff tendonitis.
[So] Source:Medicine (Baltimore);96(35):e7940, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study aimed to determine the efficacy and safety of extracorporeal shock-wave therapy (ESWT) for treating patients with chronic rotator cuff tendonitis (CRCT). METHODS: In this study, 84 patients with CRCT were randomly divided into intervention and control groups in a ratio of 1:1. Patients in the intervention group received ESWT, whereas those in the control group received placebo. The primary outcome was measured by Numeric Rating Scale (NRS). The secondary outcomes were measured by the Constant-Murley score (CMS), simple shoulder test (SST) score, and adverse events. RESULTS: Compared with placebo, ESWT showed greater efficacy in shoulder pain relief with regard to NRS score and shoulder function as measured by using CMS and SST score at 4 weeks (P < .05) and 8 weeks (P < .01) after treatment. However, no adverse events occurred in both groups. CONCLUSION: ESWT was efficacious and safe for treating patients with CRCT.
[Mh] Termos MeSH primário: Litotripsia
Lesões do Manguito Rotador/terapia
[Mh] Termos MeSH secundário: Doença Crônica
Método Duplo-Cego
Seres Humanos
Litotripsia/efeitos adversos
Meia-Idade
Lesões do Manguito Rotador/fisiopatologia
Dor de Ombro/etiologia
Dor de Ombro/terapia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007940


  7 / 9119 MEDLINE  
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[PMID]:28845938
[Au] Autor:Dutov VV; Bazaev VV; Mamedov EA; Urenkov SB; Podoinitsyn AA
[Ad] Endereço:M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia.
[Ti] Título:[Questions of terminology, systematization and grading of complications of contact ureteral lithotripsy].
[So] Source:Urologiia;(3):46-53, 2017 Jul.
[Is] ISSN:1728-2985
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To investigate the advantages and disadvantages of the current variants of systematization and grading of complications of contact ureteral lithotripsy (CULT) and develop a working classification of CULT complications. MATERIALS AND METHODS: The study analyzed results of 545 fluoroscopy-guided endoscopic procedures performed at the MRRCI Clinic of Urology from 2008 to 2015 in 506 patients with ureterolithiasis. RESULTS: The proposed and implemented classification and terminology of CULT complications unifies the diagnostic and management algorithm. This tool is more systematic and structured than the classical classification and universal methods of systematization and grading of CULT complications (classifying CULT complications in "major" and "minor", PULS scale, Satava and Clavien-Dindo grading systems). Given the lack of clear grading of ureteral rupture, it was divided into amputation (two-level rupture) and avulsion (one-level rupture). Using such term as extravasation of the contrast media and/or migration of the stone outside of the ureter is groundless because these complications occur only after the perforation of the ureteral wall. Therefore, these conditions are complications not of CULT, but of the ureteral wall perforation. The ureteral perforation was classified into macro- and micro-perforation. CONCLUSION: The existing terminology, classification and grading of the CULT complications should undergo a more detailed analysis. None of the existing classifications of CULT complications afford them to be fully staged and systematized. The working classification of complications of CULT developed at the M.F. Vladimirsky MRRCI Clinic of Urology warrants a multi-center prospective study to validate it and investigate its effectiveness.
[Mh] Termos MeSH primário: Litotripsia/efeitos adversos
Complicações Pós-Operatórias/classificação
Ruptura/etiologia
Terminologia como Assunto
Ureter/lesões
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Seres Humanos
Meia-Idade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170829
[St] Status:MEDLINE


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[PMID]:28827478
[Au] Autor:Huang SW; Tsai CY; Wang J; Pu YS; Chen PC; Huang CY; Chien KL
[Ad] Endereço:From the Department of Urology, National Taiwan University Hospital Yun-lin Branch, Douliu (S.W.H.); Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan (C.Y.T.); Departments of Urology (Y.S.P., C.Y.H.) and Internal Medicine (K.L.C.), National Taiwan Univers
[Ti] Título:Increased Risk of New-Onset Hypertension After Shock Wave Lithotripsy in Urolithiasis: A Nationwide Cohort Study.
[So] Source:Hypertension;70(4):721-728, 2017 Oct.
[Is] ISSN:1524-4563
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although shock wave lithotripsy is minimally invasive, earlier studies argued that it may increase patients' subsequent risk of hypertension and diabetes mellitus. This study evaluated the association between shock wave lithotripsy and new-onset hypertension or diabetes mellitus. The Taiwanese National Health Insurance Research Database was used to identify 20 219 patients aged 18 to 65 years who underwent the first stone surgical treatment (shock wave lithotripsy or ureterorenoscopic lithotripsy) between January 1999 and December 2011. A Cox proportional model was applied to evaluate associations. Time-varying Cox models were applied to evaluate the association between the number of shock wave lithotripsy sessions and the incidence of hypertension or diabetes mellitus. After a median follow-up of 74.9 and 82.6 months, 2028 and 688 patients developed hypertension in the shock wave lithotripsy and ureterorenoscopic lithotripsy groups, respectively. Patients who underwent shock wave lithotripsy had a higher probability of developing hypertension than patients who underwent ureterorenoscopic lithotripsy, with a hazard ratio of 1.20 (95% confidence interval, 1.10-1.31) after adjusting for covariates. The risk increased as the number of shock wave lithotripsy sessions increased. However, the diabetes mellitus risk was similar in the shock wave lithotripsy and ureterorenoscopic lithotripsy groups. Furthermore, the hazard ratio did not increase as the number of shock wave lithotripsy sessions increased. Shock wave lithotripsy consistently increased the incidence of hypertension on long-term follow-up. Therefore, alternatives to urolithiasis treatment (eg, endoscopic surgery or medical expulsion therapy) could avoid the hypertension risk. Furthermore, avoiding multiple sessions of shock wave lithotripsy could also evade the hypertension risk.
[Mh] Termos MeSH primário: Hipertensão
Litotripsia
Efeitos Adversos de Longa Duração/prevenção & controle
Urolitíase/terapia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seguimentos
Seres Humanos
Hipertensão/diagnóstico
Hipertensão/epidemiologia
Hipertensão/etiologia
Incidência
Litotripsia/efeitos adversos
Litotripsia/métodos
Litotripsia/estatística & dados numéricos
Efeitos Adversos de Longa Duração/diagnóstico
Masculino
Meia-Idade
Serviços Preventivos de Saúde/métodos
Modelos de Riscos Proporcionais
Fatores de Risco
Taiwan/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170823
[St] Status:MEDLINE
[do] DOI:10.1161/HYPERTENSIONAHA.117.09669


  9 / 9119 MEDLINE  
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[PMID]:28695783
[Au] Autor:Serbetci E; Celikoyar MM; Altundag A
[Ad] Endereço:1 Nisantasi KBB Grubu, Istanbul, Turkey.
[Ti] Título:Sialendoscopic Pneumatic Lithotripsy for Salivary Calculi: A New Technique and a Long-term Clinical Experience.
[So] Source:Otolaryngol Head Neck Surg;157(5):906-908, 2017 Nov.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:We report our results comprising a series of 34 cases of sialolithiasis that were approached sialendoscopically with conventional instruments (ie, basket and/or forceps) and for which stone removal was unsuccessful and so were thereafter treated with pneumatic lithotripsy. Intraductal pneumatic lithotripsy was able to fragment 30 of 34 (88%) salivary calculi in total. No major complications occurred. All 30 treated glands returned to normal function without any symptoms. We believe that the success of sialendoscopy is closely related to the success of salivary stone fragmentability.
[Mh] Termos MeSH primário: Endoscopia/métodos
Litotripsia/métodos
Cálculos das Glândulas Salivares/cirurgia
[Mh] Termos MeSH secundário: Desenho de Equipamento
Seres Humanos
Litotripsia/instrumentação
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170712
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817717457


  10 / 9119 MEDLINE  
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[PMID]:28631903
[Au] Autor:Martov AG; Ergakov DV; Andronov AS; Dutov SV; Takhaev RA; Kil'chukov ZI; Moskalenko SA
[Ad] Endereço:Department of Urology and Andrology, A.I. Burnazyan SSC Federal Medical Biophysical Center of FMBA of Russia, Moscow, Russia.
[Ti] Título:[Solitary stones of the lower renal calyx: how to treat?]
[So] Source:Urologiia;(2):28-35, 2017 Jun.
[Is] ISSN:1728-2985
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:INTRODUCTION: The choice of treatment for the stones of the lower renal calyx is one of the challenging issues of modern urology. The aim of this retrospective and prospective study was to investigate the clinical effectiveness and safety of 3 modern minimally invasive techniques for treating renal stones: percutaneous (PNL) and transurethral (TNL) nephrolithotripsy and extracorporeal shock wave lithotripsy (ESWL) in patients with solitary lower calyx stones sized from 10 to 15 mm. MATERIALS AND METHODS: The study included 136 patients with symptomatic stones of the lower calyces, who underwent ESWL, PNL and TNL from November 2010 to the present day. The criteria for inclusion in the study were: the presence of a solitary stone of the lower calyx, the stone size of 10 mm to 15 mm, the performance of the classical (standard) PNL in the prone position (puncture access 28-30 Fr) and the follow-up examination at 3 months after the operation. Forty-six patients underwent ESWL, 49 - PNL, and 41 - TNL. Postoperative follow-up was done at 3 months and included a plain radiography, ultrasound and non-contrast-enhanced computed tomography. The stone free rate (SFR) was used as a criterion for the effectiveness of the intervention, where the stone size of 3 mm was taken as the upper limit for the possible presence of fragments. Besides, the rate of repeat interventions, complications and subjective assessment of patients treatment satisfaction (0 to 10) by using visual analogue scale (VAS) were investigated. RESULTS: The effectiveness analysis of the three methods for treating the lower calyx stones sized 10-15 mm showed that PNL was no more effective than TNL (SFR 95.9% and 85.4%, respectively), but both methods were significantly more effective than ESWL (SFR 69.5%). 29.3% of patients who underwent TNL required repeat interventions (TNL or ESWL), while among those treated with ESWL, 45.6% required repeat ESWL sessions. PNL resulted in stone clearance in one stage. Postoperative inflammatory complications were most prevalent among patients who underwent TNL (26.8%). Bleeding requiring hemotransfusion was observed only after PNL (14.3%). Obstructive complications were observed in all study groups. For them, internal stenting was most often performed after ESWL (10.9%), puncture nephrostomy - after TNL (7.3%). Statistically significantly higher VAS measured quality of life was found after ESWL (7.9) and PNL (7.0) compared with THL (4.8). CONCLUSION: All three methods (PNL, TNL and ESWL) for treating lower calyceal stones sized from 10 to 15 mm are quite effective. Using them separately or in combination allows most patients to safely achieve a stone-free state.
[Mh] Termos MeSH primário: Cálculos Renais/cirurgia
Cálices Renais/cirurgia
Litotripsia/métodos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Qualidade de Vida
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170621
[St] Status:MEDLINE



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