Comparison of SWL and RIRS in Lower Calyceal Stones
Science Journal of Clinical Medicine
Volume 2, Issue 6, November 2013, Pages: 166-170
Received: Sep. 20, 2013; Published: Nov. 10, 2013
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Authors
Basri Cakiroglu, Hisar Intercontinental Hospital, Department of Urology, 34768 Umraniye, Istanbul, Turkey
Tuncay Tas, Taksim Training and Research Hospital, Department of Urology, 34433 Taksim, Istanbul, Turkey
Seyit Erkan Eyyupoglu, Sabuncuoglu Serefettin Training and Research Hospital, Department of Urology, 05200 Amasya, Turkey
Aydin Ismet Hazar, Taksim Training and Research Hospital, Department of Urology, 34433 Taksim, Istanbul, Turkey
M. Bahadir Can Balci, Taksim Training and Research Hospital, Department of Urology, 34433 Taksim, Istanbul, Turkey
Suleyman Hilmi Aksoy, Hisar Intercontinental Hospital, Department of Radiology, 34768 Umraniye, Istanbul,Turkey
Bekir Sami Uyanik, Hisar Intercontinental Hospital, Department of Clinical Biochemistry, 34768 Umraniye, Istanbul, Turkey
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Abstract
Background: The efficacy of extracorporeal shock wave lithotripsy(SWL) in kidney stones in the lower calices was compared using retrograde intrarenal surgery(RIRS). Methodology And Materials: Between January 2008 and May 2011, 64 patients (40 male and 24 female) undergoing SWL and 60 patients (38 male 22 female) undergoing flexible URS were analyzed retrospectively, and success rates were compared. Using the Storz Medical Modulith SLK, patients underwent the SWL process prior to the induction of anesthesia. On the other hand, the 8 f Storz flex X2 flexible URS was used for URS after general anesthesia and RIRS. During the RIRS process, stones were crushed using the 0.2 mm diameter holmium: YAG laser probe, and stone fragments larger than 2 mm were extracted. In some cases, double J or ureteral catheters were placed in the ureter. Results: In the 64 patients undergoing SWL with lower caliceal stones, the following ranges were noted: stone diameter: 6-35 mm (mean 15.9 mm), age: 16-72 years (mean , sessions required: 1-4 sessions (mean: 1.6), the number of shots: 1000-7650 (mean: 4124.6), fire intensity: 25-75 (mean: 60). Ten percent of patients required analgesia, and the success rate of the procedure was 87.5%. Hematuria occurred in 65% of patients as a minor complication and in 2%,streinstrasse occurred as a major complication. Inpatients undergoing RIRS, the following ranges were noted: stones size: 7-30 mm in diameter (average 15.2 mm), age: 21-60 years (mean 39.75),duration of operation: 30-85 minutes(mean: 48.8 minutes), respectively. An access sheath was used in all 32 patients. Balloon dilation was performed in 8 patients with distal ureteral stenosis, and a double J catheter was placed in 2 patients because of stenosis in the upper ureter and four weeks later, the stones were treated with fURS. Patients were discharged on an average of 1.2 days (1-3 days). A ureteral laceration was noted in 30% of patients while 75% of patients had hematuria. Partial ureteral avulsion occurred in one patient with an overall success rate of 96.4%. Conclusions: During the treatment of lower caliceal stones, the success and complication rate of RIRS is higher than SWL.
Keywords
Lower Calyceal Stones, SWL, RIRS, Holmium YAG Laser, Laser Lithotripsy
To cite this article
Basri Cakiroglu, Tuncay Tas, Seyit Erkan Eyyupoglu, Aydin Ismet Hazar, M. Bahadir Can Balci, Suleyman Hilmi Aksoy, Bekir Sami Uyanik, Comparison of SWL and RIRS in Lower Calyceal Stones, Science Journal of Clinical Medicine. Vol. 2, No. 6, 2013, pp. 166-170. doi: 10.11648/j.sjcm.20130206.14
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