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Factors influencing extracorporeal shock wave lithotripsy efficiency for optimal patient selection

INTRODUCTION: Current literature suggests various predictors related to the stone and patient, which could influence stone fragmentation and clearance rates. AIM: To establish clinical characteristics of stone disease for patients undergoing extracorporeal shockwave lithotripsy (ESWL) which may pred...

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Autores principales: Snicorius, Marius, Bakavicius, Arnas, Cekauskas, Albertas, Miglinas, Marius, Platkevicius, Gediminas, Zelvys, Arunas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8193744/
https://www.ncbi.nlm.nih.gov/pubmed/34136039
http://dx.doi.org/10.5114/wiitm.2021.103915
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author Snicorius, Marius
Bakavicius, Arnas
Cekauskas, Albertas
Miglinas, Marius
Platkevicius, Gediminas
Zelvys, Arunas
author_facet Snicorius, Marius
Bakavicius, Arnas
Cekauskas, Albertas
Miglinas, Marius
Platkevicius, Gediminas
Zelvys, Arunas
author_sort Snicorius, Marius
collection PubMed
description INTRODUCTION: Current literature suggests various predictors related to the stone and patient, which could influence stone fragmentation and clearance rates. AIM: To establish clinical characteristics of stone disease for patients undergoing extracorporeal shockwave lithotripsy (ESWL) which may predict the success of the procedure. MATERIAL AND METHODS: One hundred and nine patients with renal stone disease diagnosed by non-contrast computed tomography (NCCT) who underwent ESWL between January 2015 and December 2019 were included in the study. Endpoints: patient being stone free (SF) or when < 4 mm fragments were detected. Age, gender, location, skin-to-stone distance, maximum stone length, stone volume, stone surface area, mean stone Hounsfield units (HU) and highest HU score were explored in uni- and multivariate regression analysis. RESULTS: Stone size revealed the highest prognostic power for ESWL failure, where OR for stone volume and stone surface area were 1.06 (1.03–1.10) and 1.04 (1.02–1.06), respectively (all p < 0.01) while a tendency was observed for skin-to-stone distance 1.02 (1.00–1.03). The amount of energy applied during the procedure to one cubic millimeter of stone volume (SMLI/stone volume) was predictive for treatment success (OR = 0.60, 95% CI: 0.41–0.87, p < 0.01). Stone volume (OR = 1.06, 95% CI: 1.00–1.14, p = 0.01) and stone surface area (OR = 1.03, 95% CI: 1.01–1.06, p = 0.02) remained as statistically significant prognostic factors for treatment failure. CONCLUSIONS: Both greater stone volume and stone surface area, as well as lower power delivered per stone volume unit during the ESWL procedure, were found to be significant factors and could be useful to predict treatment failure.
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spelling pubmed-81937442021-06-15 Factors influencing extracorporeal shock wave lithotripsy efficiency for optimal patient selection Snicorius, Marius Bakavicius, Arnas Cekauskas, Albertas Miglinas, Marius Platkevicius, Gediminas Zelvys, Arunas Wideochir Inne Tech Maloinwazyjne Original Paper INTRODUCTION: Current literature suggests various predictors related to the stone and patient, which could influence stone fragmentation and clearance rates. AIM: To establish clinical characteristics of stone disease for patients undergoing extracorporeal shockwave lithotripsy (ESWL) which may predict the success of the procedure. MATERIAL AND METHODS: One hundred and nine patients with renal stone disease diagnosed by non-contrast computed tomography (NCCT) who underwent ESWL between January 2015 and December 2019 were included in the study. Endpoints: patient being stone free (SF) or when < 4 mm fragments were detected. Age, gender, location, skin-to-stone distance, maximum stone length, stone volume, stone surface area, mean stone Hounsfield units (HU) and highest HU score were explored in uni- and multivariate regression analysis. RESULTS: Stone size revealed the highest prognostic power for ESWL failure, where OR for stone volume and stone surface area were 1.06 (1.03–1.10) and 1.04 (1.02–1.06), respectively (all p < 0.01) while a tendency was observed for skin-to-stone distance 1.02 (1.00–1.03). The amount of energy applied during the procedure to one cubic millimeter of stone volume (SMLI/stone volume) was predictive for treatment success (OR = 0.60, 95% CI: 0.41–0.87, p < 0.01). Stone volume (OR = 1.06, 95% CI: 1.00–1.14, p = 0.01) and stone surface area (OR = 1.03, 95% CI: 1.01–1.06, p = 0.02) remained as statistically significant prognostic factors for treatment failure. CONCLUSIONS: Both greater stone volume and stone surface area, as well as lower power delivered per stone volume unit during the ESWL procedure, were found to be significant factors and could be useful to predict treatment failure. Termedia Publishing House 2021-02-24 2021-06 /pmc/articles/PMC8193744/ /pubmed/34136039 http://dx.doi.org/10.5114/wiitm.2021.103915 Text en Copyright: © 2021 Fundacja Videochirurgii https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Original Paper
Snicorius, Marius
Bakavicius, Arnas
Cekauskas, Albertas
Miglinas, Marius
Platkevicius, Gediminas
Zelvys, Arunas
Factors influencing extracorporeal shock wave lithotripsy efficiency for optimal patient selection
title Factors influencing extracorporeal shock wave lithotripsy efficiency for optimal patient selection
title_full Factors influencing extracorporeal shock wave lithotripsy efficiency for optimal patient selection
title_fullStr Factors influencing extracorporeal shock wave lithotripsy efficiency for optimal patient selection
title_full_unstemmed Factors influencing extracorporeal shock wave lithotripsy efficiency for optimal patient selection
title_short Factors influencing extracorporeal shock wave lithotripsy efficiency for optimal patient selection
title_sort factors influencing extracorporeal shock wave lithotripsy efficiency for optimal patient selection
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8193744/
https://www.ncbi.nlm.nih.gov/pubmed/34136039
http://dx.doi.org/10.5114/wiitm.2021.103915
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