Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones

Srisubat, Attasit; Potisat, Somkiat; Lojanapiwat, Bannakij; Setthawong, Vasun; Laopaiboon, Malinee

doi:10.1002/14651858.cd007044.pub3

Cited by 202 publications

(142 citation statements)

References 41 publications

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“…However, the relative importance of combining the 2 stone characteristics to predict the treatment outcome of ESWL remains to be demonstrated. In this study, ESWL had an efficacy rate of 92.2% for stones ≤400 mm 2 and those with a lower density which is comparable to the results achieved with PCNL-treated patients [26]. …”

Section: Discussionsupporting

confidence: 55%

Treatment of Renal Stones ≥20 mm with Extracorporeal Shock Wave Lithotripsy

Wang²,

Lu³

et al. 2015

Urol Int

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Aims: To identify subgroups of patients with renal stones ≥20 mm that are more suitable for extracorporeal shock wave lithotripsy (ESWL) monotherapy. Methods: A total of 376 patients with renal stones ≥20 mm underwent monotherapy with ESWL. The treatment outcome was evaluated after 3 months of follow-up. A stone-free status or fragmentation of stones to 4 mm or smaller was considered efficacious. Results: At 3 months after treatment, the overall stone-free rate was 64.4%, and the efficacy rate was 70.7%. The efficacy rate was 89.4% for patients with a residual stone surface area ≤50% of baseline after the first ESWL, while the efficacy rate was 32.4% for other patients. The efficacy was 92.2% for stones ≤400 mm² and those with lower radiodensity, as determined by a plain (KUB) film. Conclusions: For renal stones with a surface area ≤400 mm² and a radiodensity equal to or less than that of the 12th rib as determined by a KUB film, ESWL may be considered the first line of treatment, even for stones with a diameter ≥20 mm. For large stones requiring repeat treatments, the surface area of the residual stones after the first ESWL is a predictor of the final treatment result.

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Section: Discussionsupporting

confidence: 55%

Treatment of Renal Stones ≥20 mm with Extracorporeal Shock Wave Lithotripsy

Wang²,

Lu³

et al. 2015

Urol Int

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“…Other factors, including stone composition and body mass index (BMI), may also influence the success rates of SWL and micro-PNL [16,17]. Although some patients' information was not available (27.6%), the distribution of stone component was as follows: Calcium oxalate monohydrate 47.3%, uric acid 12.4%, calcium phosphate 16.6%, struvite 9.4%, calcium oxalate dihydrate 6.3%, and cystine 8%.…”

Section: Discussionmentioning

confidence: 99%

Is Micropercutaneous Nephrolithotomy Technique Really Efficacicous for the Treatment of Moderate Size Renal Calculi? Yes

Karatag

Buldu²,

Inan³

et al. 2015

Urol Int

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Objective: To present our clinical experiences with micropercutaneous nephrolithotomy in the treatment of moderate-sized renal calculi from a single center. Methods: We retrospectively evaluated the patients with moderate-sized renal calculi who underwent micro-percutaneous nephrolithotomy between December 2012 and Septermber 2013. Results: A total of 68 patients and 70 renal units underwent microperc procedure. Mean age of patients was 41.4 ± 18.8. The mean stone size was 122 ± 83 mm². The operations were performed under spinal anesthesia in 89.7% of the patients. Stone-free rate was 95.7 % (67/70). Clinically significant residual fragments were observed in three patients. The average duration of operation and mean fluoroscopy time was 40 ± 23 min and 108 ± 72 s, respectively. The mean postoperative drop in hemoglobin was 0.95 ± 0.7 while no patient required blood transfusion. Patients were discharged after an average hospitalization time of 27.5 ± 12.4 h. A total of 4 complications (5.7%), including urinary tract infection (Clavien I) in one patient and renal colics requiring stent insertion (Clavien IIIa) in three patients, were observed postoperatively. Conclusion: Microperc technique is safe, feasible, and efficacious. We suggest that micro-percutaneous nephrolithotomy should be considered for the treatment of moderate-sized renal stones as an alternative to SWL and RIRS failures and also may be considered even primarily.

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“…Although currently available stone removal techniques, such as extracorporeal shock wave lithotripsy (ESWL), ureteroscopy (URS), and percutaneous nephrolithotomy (PNL), are considered effective, they are costly. Thus, these techniques are an option for only a limited number of patients [3]. Additionally, compelling data suggest that these techniques have some serious side effects [3].…”

Section: Introductionmentioning

confidence: 99%

Calcium Oxalate Induces Renal Injury through Calcium‐Sensing Receptor

Shi

et al. 2016

Oxidative Medicine and Cellular Longevity

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Objective. To investigate whether calcium-sensing receptor (CaSR) plays a role in calcium-oxalate-induced renal injury. Materials and Methods. HK-2 cells and rats were treated with calcium oxalate (CaOx) crystals with or without pretreatment with the CaSR-specific agonist gadolinium chloride (GdCl3) or the CaSR-specific antagonist NPS2390. Changes in oxidative stress (OS) in HK-2 cells and rat kidneys were assessed. In addition, CaSR, extracellular signal-regulated protein kinase (ERK), c-Jun N-terminal protein kinase (JNK), and p38 expression was determined. Further, crystal adhesion assay was performed in vitro, and the serum urea and creatinine levels and crystal deposition in the kidneys were also examined. Results. CaOx increased CaSR, ERK, JNK, and p38 protein expression and OS in vitro and in vivo. These deleterious changes were further enhanced upon pretreatment with the CaSR agonist GdCl3 but were attenuated by the specific CaSR inhibitor NPS2390 compared with CaOx treatment alone. Pretreatment with GdCl3 further increased in vitro and in vivo crystal adhesion and renal hypofunction. In contrast, pretreatment with NPS2390 decreased in vitro and in vivo crystal adhesion and renal hypofunction. Conclusions. CaOx-induced renal injury is related to CaSR-mediated OS and increased mitogen-activated protein kinase (MAPK) signaling, which subsequently leads to CaOx crystal adhesion.

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Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones

Cited by 202 publications

References 41 publications

Treatment of Renal Stones ≥20 mm with Extracorporeal Shock Wave Lithotripsy

Treatment of Renal Stones ≥20 mm with Extracorporeal Shock Wave Lithotripsy

Is Micropercutaneous Nephrolithotomy Technique Really Efficacicous for the Treatment of Moderate Size Renal Calculi? Yes

Calcium Oxalate Induces Renal Injury through Calcium‐Sensing Receptor

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