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Comparison of Percutaneous Nephrolithotomy Using Pneumatic Lithotripsy (Lithoclast®) Alone or in Combination with Ultrasonic Lithotripsy

PURPOSE: Percutaneous nephrolithotomy (PCNL) is the procedure of choice for treating large renal stones. Pneumatic lithotripsy (Lithoclast®) is effective regardless of the stones' composition, and ultrasonic lithotripsy allows the aspiration of small debris during lithotripsy. We investigated t...

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Autores principales: Cho, C one, Yu, Ji Hyeong, Sung, Luck Hee, Chung, Jae Yong, Noh, Choong Hee
Formato: Texto
Lenguaje:English
Publicado: The Korean Urological Association 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991577/
https://www.ncbi.nlm.nih.gov/pubmed/21165200
http://dx.doi.org/10.4111/kju.2010.51.11.783
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author Cho, C one
Yu, Ji Hyeong
Sung, Luck Hee
Chung, Jae Yong
Noh, Choong Hee
author_facet Cho, C one
Yu, Ji Hyeong
Sung, Luck Hee
Chung, Jae Yong
Noh, Choong Hee
author_sort Cho, C one
collection PubMed
description PURPOSE: Percutaneous nephrolithotomy (PCNL) is the procedure of choice for treating large renal stones. Pneumatic lithotripsy (Lithoclast®) is effective regardless of the stones' composition, and ultrasonic lithotripsy allows the aspiration of small debris during lithotripsy. We investigated the efficacy and safety of PCNL via Lithoclast® alone or combined with ultrasonic lithotripsy. MATERIALS AND METHODS: Thirty-five (group A) and 39 (group B) patients underwent Lithoclast® PCNL and combination therapy, respectively, from May 2001 to March 2010, and the two groups were compared in terms of stone size, location, and composition; operative time; average number of treatments; hospital days; hemoglobin loss; ancillary procedures; rate of device failure; and initial and total stone-free rates. RESULTS: The two groups did not differ significantly in preoperative stone size, location, or composition; the average number of treatments; or the initial and overall stone-free rates. However, combination therapy was associated with a significantly lower operative time (181±50 vs. 221±65 min, respectively, p=0.004), number of hospital days (11.6±3.8 vs. 14.2±4.4 days, respectively, p=0.009), and average hemoglobin loss (1.12±0.61 vs. 1.39±1.02 g/dl, respectively, p=0.013). Transfusions were required in 6 patients (4 and 2 in each group, respectively), but there were no significant complications related to percutaneous access. There were 2 (5.7%) mechanical failures (Lithoclast® probe fracture) in the group A and 5 (12.8%) in the group B (2 cases of suction tube obstruction, 3 cases of overheating). CONCLUSIONS: The combination of ultrasonic lithotripter and Lithoclast® is more effective than Lithoclast® alone because it significantly decreases operative time, hemoglobin loss, and the hospital stay. This may reflect the superior power of Lithoclast® and the ability to aspirate the debris during ultrasonic lithotripsy.
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spelling pubmed-29915772010-12-16 Comparison of Percutaneous Nephrolithotomy Using Pneumatic Lithotripsy (Lithoclast®) Alone or in Combination with Ultrasonic Lithotripsy Cho, C one Yu, Ji Hyeong Sung, Luck Hee Chung, Jae Yong Noh, Choong Hee Korean J Urol Original Article PURPOSE: Percutaneous nephrolithotomy (PCNL) is the procedure of choice for treating large renal stones. Pneumatic lithotripsy (Lithoclast®) is effective regardless of the stones' composition, and ultrasonic lithotripsy allows the aspiration of small debris during lithotripsy. We investigated the efficacy and safety of PCNL via Lithoclast® alone or combined with ultrasonic lithotripsy. MATERIALS AND METHODS: Thirty-five (group A) and 39 (group B) patients underwent Lithoclast® PCNL and combination therapy, respectively, from May 2001 to March 2010, and the two groups were compared in terms of stone size, location, and composition; operative time; average number of treatments; hospital days; hemoglobin loss; ancillary procedures; rate of device failure; and initial and total stone-free rates. RESULTS: The two groups did not differ significantly in preoperative stone size, location, or composition; the average number of treatments; or the initial and overall stone-free rates. However, combination therapy was associated with a significantly lower operative time (181±50 vs. 221±65 min, respectively, p=0.004), number of hospital days (11.6±3.8 vs. 14.2±4.4 days, respectively, p=0.009), and average hemoglobin loss (1.12±0.61 vs. 1.39±1.02 g/dl, respectively, p=0.013). Transfusions were required in 6 patients (4 and 2 in each group, respectively), but there were no significant complications related to percutaneous access. There were 2 (5.7%) mechanical failures (Lithoclast® probe fracture) in the group A and 5 (12.8%) in the group B (2 cases of suction tube obstruction, 3 cases of overheating). CONCLUSIONS: The combination of ultrasonic lithotripter and Lithoclast® is more effective than Lithoclast® alone because it significantly decreases operative time, hemoglobin loss, and the hospital stay. This may reflect the superior power of Lithoclast® and the ability to aspirate the debris during ultrasonic lithotripsy. The Korean Urological Association 2010-11 2010-11-17 /pmc/articles/PMC2991577/ /pubmed/21165200 http://dx.doi.org/10.4111/kju.2010.51.11.783 Text en Copyright © The Korean Urological Association, 2010 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Cho, C one
Yu, Ji Hyeong
Sung, Luck Hee
Chung, Jae Yong
Noh, Choong Hee
Comparison of Percutaneous Nephrolithotomy Using Pneumatic Lithotripsy (Lithoclast®) Alone or in Combination with Ultrasonic Lithotripsy
title Comparison of Percutaneous Nephrolithotomy Using Pneumatic Lithotripsy (Lithoclast®) Alone or in Combination with Ultrasonic Lithotripsy
title_full Comparison of Percutaneous Nephrolithotomy Using Pneumatic Lithotripsy (Lithoclast®) Alone or in Combination with Ultrasonic Lithotripsy
title_fullStr Comparison of Percutaneous Nephrolithotomy Using Pneumatic Lithotripsy (Lithoclast®) Alone or in Combination with Ultrasonic Lithotripsy
title_full_unstemmed Comparison of Percutaneous Nephrolithotomy Using Pneumatic Lithotripsy (Lithoclast®) Alone or in Combination with Ultrasonic Lithotripsy
title_short Comparison of Percutaneous Nephrolithotomy Using Pneumatic Lithotripsy (Lithoclast®) Alone or in Combination with Ultrasonic Lithotripsy
title_sort comparison of percutaneous nephrolithotomy using pneumatic lithotripsy (lithoclast®) alone or in combination with ultrasonic lithotripsy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991577/
https://www.ncbi.nlm.nih.gov/pubmed/21165200
http://dx.doi.org/10.4111/kju.2010.51.11.783
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