The lithotripsy table height: a novel predictor of outcome in shockwave lithotripsy
Int. braz. j. urol
;
37(3): 355-361, May-June 2011. ilus, graf, tab
Artículo
en Inglés
| LILACS
| ID: lil-596010
ABSTRACT
BACKGROUND:
Outcome of Extracorporeal Shockwave Lithotripsy (SWL) is determined by physical factors that affect stone fragmentation and clearance.PURPOSE:
To evaluate the predictive value of the Lithotripsy Table Height (LTH) in SWL outcome. Lithotripsy Table Height (LTH) is a variable that represents skin to therapy head distance, and it is proportional to the energy that reaches the stone. MATERIALS ANDMETHODS:
A prospective study enrolled patients undergoing SWL for radiopaque urinary stones. All procedures were performed using a Modulith SLX (Karl Storz, Germany) Lithotripter. Patient weight, height and age; stone location and size; number of shock waves delivered, and LTH were recorded. One month post-procedure a KUB was obtained. Logistic regression analysis was used to evaluate the effects of these variables on stone-free outcome. A ROC curve was plotted.RESULTS:
Fifty-six patients were enrolled. After one month follow-up, overall success rate (Stone Free) was 83.9 percent (n = 47). LTH was the only independent predictor of outcome in both univariate and multivariate analysis (p = 0.029). Stone size (p = 0.45) and BMI (p = 0.32) were not significant. In the ROC curve, LTH showed an Area under the Curve = 0.791. Patients with LTH < 218 (n = 8) had relative risk of residual stones = 7.5, odds Ratio 6.6 (Stone free rate 37.5 percent vs. 91.5 percent).CONCLUSION:
LTH appears to be an independent predictor of SWL outcome. High success rates can be expected if LTH > 218. Patients with lower LTH had a less effective therapy, therefore, worse stone fragmentation and clearance. These findings may help improve patient selection for SWL therapy.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Litotricia
/
Cálculos Urinarios
/
Mesas de Operaciones
Límite:
Adulto
/
Femenino
/
Humanos
/
Masculino
País/Región como asunto:
America del Sur
/
Chile
Idioma:
Inglés
Revista:
Int. braz. j. urol
Asunto de la revista:
Urología
Año:
2011
Tipo del documento:
Artículo
País de afiliación:
Chile
Institución/País de afiliación:
Universidad de Chile/CL
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