体外衝撃波による上部尿路結石破砕術(ESWL) の経験

Abstract

1)上部尿路結石100例に対してESWLを施行し1～3ヵ月の経過観察で73例に完全排石をみた.残りの症例も15例は砂状結石または5 mm以下の小結石で自然排石が期待でき経過不明の10例を除くと97.7%に満足のいく結果が得られた.2)長径3 cm以上のいわゆる"problem stone"や鋳型結石ではendourological techniquesを使用する必要が多かった.3) ESWLは結石の理想的な治療法に近く器械や周辺技術の進歩とともに今後結石治療の中心となると考える

We treated 100 patients of upper urinary tract stone using extracorporeal shock wave lithotripsy (ESWL), from April to October 1986. Eighty-six of the patients were treated by ESWL monotherapy, and the other cases required further treatment, such as percutaneous nephrostomy (PCN), percutaneous nephrolithotomy (PNL), and transurethral ureterolithotripsy (TUL). On the X-ray film obtained from one to three months after ESWL, 73 patients had no stones, 8 patients had sandy stones, 7 patients had small fragments less than 5 mm, 2 patients had large stones equal to or greater than 5 mm and 10 patients could not be followed up. Therefore, 97.7% of all patients were successfully treated. In conclusion, ESWL is considered to be an ideal method to treat upper urinary tract stones, and soon will become the first choice of treatment of urolithiasis together with the progress in endourological techniques.