Dornier Lithotripter Compactによる上部尿路結石の治療経験

Abstract

Dornier Lithotripter Compactを用いて30症例に対し無麻酔で32個の上部尿路結石の治療を行った.3ヵ月後の治療成績は12例で残石を認めず, 6例で4.0 mm以下の, 4例で4.1 mm以上ではあるが自排が期待できる残石を認めた.すなわち, 22例の症例で期待された結石破砕効果を認め, 上部尿路結石の治療において他の大型機種に劣らぬ有効性を持つ

The results of clinical application of a Dornier Lithotripter Compact (Dornier Medical Systems Co., Ltd.) on upper urinary tract stones are presented. Between October 1991 and June 1992, 30 patients with upper urinary tract stones were treated with ESWL in the Department of Urology, Kyoto University. Although 49 sessions for 32 stones in total were carried out without anesthesia, analgesics such as indomethacin and/or pentazocine were required in 37 sessions (76%). Stone-free rate 3 months after the last session was 12/30 cases (40%) and the success rate, the ratio of the patients without residual stone or with residual stones less than 4 mm to total 30 patients, was 18/30 (60%) at the point. Macrohematuria was seen after the treatment in 42/49 (86%) sessions, but it disappeared within 3 days in all instances. Pain necessitating analgesics after the treatment was seen in 16/49 (33%) sessions. Subcutaneous bleeding and fever-up of less than 38 degrees C were seen in 15/49 (31%) and 8/49 (16%) sessions, respectively, but bacteremia after the treatment was not detected in any case. No serious adverse effects were observed in blood chemistry. The Dornier Lithotripter Compact is considered to be useful in the treatment of renal and upper third ureteral stones.