単腎の上部尿路結石5症例に対するESWLの治療経験

Abstract

単腎患者の上部尿路結石(腎結石4例, 下部尿管結石1例)に対するESWLの治療成績とともに, 本症におけるESWLの有効性および安全性を検討した.1)著効4例および有効1例で, 腎結石4例はESWLの単独療法で破砕排石を認めた.尿管結石例は腎瘻の増設を行った.2)治療回数は1～最高10回で, 治療終了後1ヵ月の血圧, 血算, 血液生化学および尿中酵素値やDIP像において異常を認めた症例はなく, 腎機能の面からも安全であった.3) ESWLは単腎患者でも有効でかつ安全な治療成績が得られ, また腎結石例では尿管ステントなどの補助療法は不要であった

We performed extracorporeal shock wave lithotripsy (ESWL) to 5 solitary kidney patients with upper urinary tract stones (4 kidneys and 1 lower ureter) using the EDAP lithotripter LT-01 and achieved 4 complete and 1 well results. The size of stones ranged from 8 mm to staghorn and trials were 1 to 10 units. We could accomplish perfect crushing and abortion of stones in the 4 renal stone patients without any adjuvant systems as ureteral stent but nephrostomy was needed in the 1 lower ureteral stone patient developed anuria. The values of blood pressure, hematology, blood chemical constituents and urine excretion enzymes at a month after the last ESWL were not so changed compared with those of preoperation and also excretory urogram showed favorable findings. In this series decreased renal functions by ESWL were not observed. We confirmed ESWL was an effective and a safe method even in the cases of solitary kidney patients and monotherapy without any adjuvants was possible.