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
Article
Dans Anglais
| 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.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Lithotritie
/
Calculs urinaires
/
Tables d'opération
Type d'étude:
Etude diagnostique
/
Etude d'étiologie
/
Études d'évaluation
/
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Adulte
/
Femelle
/
Humains
/
Mâle
Pays comme sujet:
Amérique du Sud
/
Chili
langue:
Anglais
Texte intégral:
Int. braz. j. urol
Thème du journal:
Urologie
Année:
2011
Type:
Article
Pays d'affiliation:
Chili
Institution/Pays d'affiliation:
Universidad de Chile/CL
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