Abstract
Recently published data indicate that morbidity after ESWL of large renal calculi (> 2 cm) can be significantly diminished by inserting a ureteral double-J stent prior to treatment. A prospective, randomized study was designed to clarify if ESWL plus ureteral stenting is preferable to the combination of PNL/ESWL for the treatment of large renal calculi (> 2.5 cm) and staghorn stones. To date 74 patients have entered the study; preliminary data of 53 patients are available.
Complications (bleeding, septicemia, deterioration of renal function) are significantly more frequent following PNL/ESWL, whereas the need for auxiliary measures (mainly percutaneous nephrostomies) is greater following stent/ESWL. Results after an average follow-up of three months indicate that only 15% of patients treated with ESWL and ureteral stenting were free of stones, suggesting that longer follow-up is necessary for the assessment of the definitive value of this treatment modality in the treatment of large renal calculi. With the availability of anesthesia-free ESWL in the Dornier HM3, this topic is currently of particular interest.
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References
Abomelha MS, Said MT, Otaibi KE, et al: ESWL monotherapy in staghorn calculi. V World Congress on Endourology and ESWL. Cairo, 1987.
Alken P, Scharfe T, Rorig J, et al: Staghorn stones: surgery or ESWL and PNL? V World Congress on Endourology and ESWL. Cairo, 1987.
Chaussy CG, Schmiedt E, Jocham D, et al: First clinical experience with extracorporeally induced destruction of kidney stones by shock waves. J Urol 127: 417, 1982.
Drach GW, Dretler SP, Fair WR, et al: Report of the United States cooperative study of extracorporeal shock wave lithotripsy. J Urol 135: 1127, 1986.
Eisenberger F, Rassweiler J, Bub P, et al: Differentiated approach to staghorn calculi using extracorporeal shock wave lithotripsy and percutaneous nephrolithotripsy: an analysis of 151 consecutive cases. World J Urol 5: 248, 1987.
Fuchs G, Miller K, Rassweiler J, et al: One-year experience with Dornier lithotripter. Eur Urol 11: 145, 1985.
Graff J, Pastor J, Herberhold D, et al: Technical modifications of the Dornier HM3 lithotripter with an improved anesthesia technique. World J Urol 5: 202, 1987.
Groenveld AE: ESWL monotherapy in large stone burdens. V World Congress on Endourology and ESWL. Cairo, 1987.
Libby J, Meacham RB, Griffith DG: Role of silicone ureteral stents in extracorporeal shock wave lithotripsy of large renal calculi. J Urol 139: 15, 1988.
Lingeman JE: Current concepts on the relative efficacy of percutaneous nephrostolithotomy and extracorporeal shock wave lithotripsy. World J Urol 5: 229, 1987.
Miller K, Bachor R, Hautmann R: Percutaneous nephrolithotomy/ESWL versus ureteral stent/ESWL for the treatment of large renal calculi and staghorn stones: a prospective randomized study. V World Congress on Endourology and ESWL. Cairo, 1987.
Patterson DE, Segura JW, LeRoy AJ: Long-term follow-up of patients treated by percutaneous ultrasonic lithotripsy for struvite staghorn calculi. J Endourol 1: 177, 1987.
Snyder JA, Rosenblum JL, Smith AD: Endourological removal of staghorn calculi in the elderly: analysis of 42 cases. J Endourol 1: 123, 1987.
Tiselius HG, Hellgren E, Wall I: Infectious staghorn stones treated with ESWL and hemiacidrin irrigation. J Endourol 2: 137, 1988.
Zwergel U, Neisius D, Zwergel T, et al: Results and clinical management of extracorporeal piezoelectric lithotripsy (EPL) in 1,321 consecutive treatments. World J Urol 5: 213, 1987.
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© 1988 Springer Science+Business Media New York
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Miller, K., Bachor, R., Hautmann, R. (1988). Percutaneous Nephrolithotomy and ESWL versus Ureteral Stent and ESWL for the Treatment of Large Renal Calculi and Staghorn Calculi: Preliminary Results of a Prospective, Randomized Study. In: Lingeman, J.E., Newman, D.M. (eds) Shock Wave Lithotripsy. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-1977-2_17
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DOI: https://doi.org/10.1007/978-1-4757-1977-2_17
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4757-1979-6
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