LithostarによるExtracorporeal shock wave lithotripsy単独治療の検討 : 累積残石率に影響を与える因子

Abstract

713例の腎尿管結石について, ESWL開始後の累積残石率を検討した。1) 713例全例の累積残石率は, ESWL開始後3ヵ月で41.6%, 以後6ヵ月;30.5%, 12ヵ月;20.6%, 48ヵ月;10.3%で, 治療開始後最初の1年で約80%が完全排石し, その後3年間に約10%が完全排石に至った。2)結石が大きいほど高い累積残石率を示した。3)長径2cm以下の結石では, 腎結石は尿管結石より高い累積残石率を示した。4)長径1～2cmの腎結石では, 対象結石が複数の場合は単数の場合より高い累積残石率を示した

For the evaluation of post treatment course after initial extracorporeal shock wave lithotripsy (ESWL) as a monotherapy using the Lithostar, the actuarial residual stone rate (ARSR) was calculated by the Kaplan-Meier formula in 713 calculi (255 renal and 458 ureteral calculi). ARSRs in all calculi at 3, 6, 12 and 48 months were 41.6, 30.5, 20.6 and 10.3%, respectively. Significantly higher ARSRs were observed in the following former group compared to the latter: large calculi to small or middle sized calculi, renal calculi to ureteral calculi (small or middle sized), and plural renal calculi (middle sized) to single renal calculi (middle sized). There was no significant difference either between large renal and large ureteral calculi, or overall single and plural calculi. These findings show that ARSRs calculated by the Kaplan-Meier formula clearly reveal factors influencing the ESWL effects.