RESUMO
Objective: To compare the effectiveness of laser lithotripsy [LL] and pneumatic lithotripters [PL] in calcium oxalate [CaOx] and calcium phosphate [CaP] stones and assess whether these stone compositions affect the outcomes of LL and PL
Study Design: Comparative, descriptive study
Place and Duration of Study: Istanbul Training and Research Hospital, Turkey, from August 2010 to August 2015
Methodology: A total of 114 patients underwent ureteroscopy using LL and PL. Fifty-eight [50.9%] had CaOx stones and 56 [49.1%] had CaP stones. The lithotripters were compared in stone composition groups, and stone compositions were compared in lithotripter groups. Patient characteristics, perioperative parameters, and postoperative complications were compared
Results: The baseline patient and stone characteristics were similar in all groups. The operation time of the PL and LL for the patients with CaP stones [68.75 +/- 32.88 and 44.48 +/- 34.37 minutes, respectively] was significantly shorter than the operation time of the PL and LL for the patients with CaOx stones [91.56 +/- 30.54 and 65.75 +/- 37.74 minutes, [p=0.012 and p=0.009, respectively]. Moreover, the patients with CaOx or CaP treated with LL [65.75 +/- 37.74 and 44.48 +/- 34.37 minutes, respectively] had significant shorter operation time than the PL [91.56 +/- 30.54 and 68.75 +/- 32.88 minutes, [p=0.046 and p=0.01, respectively]. Stone-free rates were similar in all groups. The PL for the patients with CaP stones caused more postoperative fever and infection than the other groups [p=0.050]
Conclusion: Though both PL and LL are effective in the treatment of CaOx and CaP stones, LL had a significantly shorter operation and hospitalization time and complication rates in patients with CaOx and CaP stones. So LL is a more feasible and safer modality in the treatment of recurrent CaP stones