ABSTRACT
Objective:To evaluate and compare the effciency and safety of Cyberwand dual probe lithotriptor and Swiss lithoclast master in percutaneous nephrolithotomy for renal staghorn calculi. Methods:A total of 138 patients with renal staghorn calculi were divided randomly into a Cyberwand dual probe lithotripter group (Group A, n=71) and a Swiss lithoclast master group(Group B, n=67). hTe data for operative time, blood loss volume, one-stage calculus clearance rate, hospitalization time, cost of hospitalization and complication in the two groups were collected and compared. Results: The renal access was established successfully and the one-stage percutaneous nephrolithotomy (PCNL) was performed in the 2 groups. There was no significant difference in the size of stones, the age of patients and the complications between the 2 groups before the operations. Intraoperative gravel time in the Group A was signiifcantly shorter than that in the Group B (77.14±21.39 vs 84.25±20.62, P=0.049). There was no significant difference in the one-staged stone clearance rate, blood loss volume in the operation between the 2 groups. hTe one-staged stone clearance rate in the 2 groups were 67.6%(48/71) and 70.1%(47/67) respectively, with no signiifcant difference (P=0.854). Conclusion:Two lithotrities were safe and effcient for renal staghorn calculi. But comparing with Swiss lithoclast master, Cyberwand dual probe lithotriptor is more effcient and convenient.
ABSTRACT
At present the techniques available for performing intracorporeal lithotripsy include electrohydraulic, ultrasonic, laser, and ballistic lithotripsy. We present our experience with a unique technology for performing intracorporeal lithotripsy, namely the Swiss lithoclast, which is a form of ballistic lithotripsy. This simple and inexpensive device uses compressed air to activate a solid probe in a manner similar to that of a jackhammer. We report the use of this lithoclast in 92 patients involving a total of 95 ureteral calculi. The lithoclast successfully fragmented 81 of the 95 calculi, a success rate of 85.26%. There were no major complications directly related to the use of this device. The Swiss lithoclast seems to be a safe, effective and an inexpensive means of performing intracorporeal lithotripsy for ureteral calculi.
ABSTRACT
Objective To study the feasibility,superiority and curative effect of percutaneous nephrolithotomy with fibrous sheath and Swiss LithoClast Master (EMS Ⅲ) through T-tube tract for retained choledocholithiasis. Methods This study involved 32 patients with hepatolithiasis who were treated in our hospital from August 2004 to August 2007. By combining percutaneous nephrolithotomy (with a fibrous sheath on) and Swiss LithoClast Master (EMS Ⅲ) through a T-tube tract,retained choledocholithiasis was removed. Results The 32 patients totally underwent 36 operations. The mean operation time was 43 minutes (ranged from 33 to 78 minutes). In 28 of the cases,the stones were extracted completely by one session; and 2 were cured by two operations. The final stone-free rate was 94% (30/32). Follow-up was carried out in all the patients for 26 to 48 months (mean,29 months),during which no patients developed abdominal pain,jaundice or fever,no recurrence was detected by B-ultrasonography. Two patients showed residual stones after the treatment,one of them received Roux-en-Y hepatocholangioenterostomy because of extensive multiple biliary stones in the liver,which could no be removed completely after three sessions of nephrolithotomy; another patient who was a 70-year old man refused the secondary operation and thus retained a few stones in the right inferior lobe of the liver. In this series of 32 cases,no bile duct tear,massive hemorrhage,biliary leakage,cholangitis or abdominal distension occurred. Conclusions It is a safe,convenient,and simple method to combine percutaneous nephrolithotomy with Swiss LithoClast Master via T-Tube tract for retained choledocholithiasis. The procedure results in less pain in patients,and reduced equipment spoilage,while the cost is low. As the surgery is easy to perform,it is worth being widely used.