Siemens Lithostar2による上部尿路結石の治療経験

Abstract

上部尿路結石患者414名(男287例, 女127例, 20～83歳)を対象とした. 1)最終治療3ヵ月後の有効率は腎結石で82.4%, 尿管結石で88.1%. 2)ESWL単独による治療には限界もあり, 尿管結石において3度のESWL治療でも結石に変化の認められない症例ではTULを施行すべきと考えられた. 3)外科的治療を必要とするような重篤な副作用は認めなかった. 4)Siemens Lithostar 2は上部尿路結石の治療に対して有用である

Between May 1994 and March 1996, a total of 427 cases of upper urinary tract stones were treated by extracorporeal shock wave lithotripsy (ESWL) using a Siemens Lithostar2. Of 427 patients, 167 had renal stones and 260 had ureteral calculi. A double J stent was inserted preoperatively for patients with stones > or = 20 mm in diameter. The success rate after 3 months, defined as complete disappearance of stone or partial disintegration with residual stones < or = 4 mm in diameter, was 82.4% and 88.1% for the renal and ureteral calculi, respectively. Additional treatments were required in 9 cases (transurethral ureterolithotripsy in 5, percutaneous nephrostomy in 2, nephrolithotripsy and ureterolithotomy in 1 each). There were no serious side effects requiring surgical treatment or blood transfusion, although perirenal hematoma developed in 5 patients, who were treated conservatively. It is concluded that ESWL using Simens Lithostar 2 is safe and useful for treating upper urinary tract stones.