両側尿管結石及び単腎例の尿管結石に対するESL-500Aを用いたIn situ ESWLの治療成績

Abstract

体外衝撃波結石粉砕術(ESWL)を施行した21例の治療成績を検討した.11例は外来通院, 10例は入院により治療を行った.両側尿管結石は18例, 単腎例は3例(単腎の尿管結石1例, 機能的単腎の尿管結石2例)であり, 2例に補助療法を併用した.初回のin situ ESWLで先行治療側が完全排石したのは17例で, その内治療初日に両側とも完全排石できたのは6例であった.最終的に18例が両側とも完全排石できた.ESWLによる敗血症や腎被膜下血腫等の重大な合併症は認めなかった

Extracorporeal shock wave lithotripsy (ESWL) using ESL-500A was performed for the treatment of 18 cases of bilateral ureteral stones and 3 cases of a solitary or a functionally solitary kidney with ureteral stones from September 1991 to February 2000. Sixteen cases of the former and all 3 cases of the latter were treated by in situ ESWL, and the other 2 cases of bilateral ureteral stones were treated with auxiliary procedures. No residual stones were observed in any cases except for one of bilateral ureteral stones treated by in situ ESWL. The results show that in situ ESWL using ESL-500A seems to be useful for the treatment of bilateral ureteral stones and ureteral stones in a solitary kidney, including a functionally solitary kidney. However, auxiliary treatment will be needed in cases of urinary tract infection, undetectable stones by ultrasonography, or bilateral large stones.