Abdominal fat distribution on computed tomography predicts ureteric calculus fragmentation by shock wave lithotripsy

Juan, Hsu-Cheng; Lin, Hung-Yu; Chou, Yii‐Her; Yang, Yi‐Hsin; Shih, Paul Ming-Chen; Chuang, Sung-Kiang; Shen, Jung-Tsung; Juan, Yung‐Shun

doi:10.1007/s00330-012-2413-6

Cited by 17 publications

(8 citation statements)

References 28 publications

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“…Juan et al showed the impact of SSD on the obtained results of ESWL while SSD more than 10 cm is likely led to treatment failure. Their results are also consistent with our finding (15).…”

Section: Discussionsupporting

confidence: 94%

Impact of body mass index on success, complications and failure of extracorporeal shock wave lithotripsy

et al. 2019

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Introduction: Extracorporeal shock wave lithotripsy (ESWL) is known as the most common method in treating urinary stones (70%) and is a selective method to treat small urinary stones (<2-2.5 cm). General opinion is that the success rate of ESWL in obese patients is low and risk of complications is high. Objectives: The aim of this study was to evaluate the impact of body mass index (BMI) and the stone-to-skin distance on success, complications and failure of ESWL. Patients and Methods: In this study, 222 patients who referred to lithotripsy clinic of Kashani hospital of Shahrekord to break stones with diameters of 5 to 20 mm participated in the study. Their urinary stones were in kidneys, lower calyces, upper calyces, pelvis or proximal ureter and were divided into two equal groups of BMI >25 kg/m2 and BMI <25 kg/m2 . Assessing the position and diameter of the stones was based on radiographic findings such as sonography and CT scan. Regarding success, failure and complications of lithotripsy, two groups were compared. Results: Around 105 and 117 patients out of 222 subjects, were respectively assigned in BMI>25 kg/ m2 and BMI <25 kg/m2 groups. The failure and success of both groups were statistically significant (P=0.023). In terms of treatment outcomes, difference between two groups was high in low skinto-stone distance (SSD). Logistic regression showed that both BMI and SSD are effective factors in treating the stone while SSD was more effective (P=0.004) than BMI (P=0.023) since SSD>7.5 cm predicts treatment failure. Conclusion: BMI and SSD are effective factors on the outcome of ESWL. Higher BMI and SSD> 7.5 cm are effective factors on treatment failure.

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“…Juan et al showed the impact of SSD on the obtained results of ESWL while SSD more than 10 cm is likely led to treatment failure. Their results are also consistent with our finding (15).…”

Section: Discussionsupporting

confidence: 94%

Impact of body mass index on success, complications and failure of extracorporeal shock wave lithotripsy

et al. 2019

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“…Several studies have shown that NCCT provides a rapid assessment of the stone size, stone surface area, HU density, SSD, stone number, and stone location, and all these parameters have attempted to predict the successful rate of SWL [13,17]. Recently, several investigators have demonstrated that BMI, AD CT , and intra‐abdominal fat distribution can also help to predict the outcome of SWL [10,18–20]. In the present study, we tried to combine these potential parameters, which were available by NCCT, to predict the outcome after shockwave lithotripsy.…”

Section: Discussionmentioning

confidence: 99%

Noncontrast computed tomography can predict the outcome of shockwave lithotripsy via accurate stone measurement and abdominal fat distribution determination

Geng¹,

Tu²,

Shih³

et al. 2014

The Kaohsiung J of Med Scie

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Urolithiasis is a common disease of the urinary system. Extracorporeal shockwave lithotripsy (SWL) has become one of the standard treatments for renal and ureteral stones; however, the success rates range widely and failure of stone disintegration may cause additional outlay, alternative procedures, and even complications. We used the data available from noncontrast abdominal computed tomography (NCCT) to evaluate the impact of stone parameters and abdominal fat distribution on calculus-free rates following SWL. We retrospectively reviewed 328 patients who had urinary stones and had undergone SWL from August 2012 to August 2013. All of them received pre-SWL NCCT; 1 month after SWL, radiography was arranged to evaluate the condition of the fragments. These patients were classified into stone-free group and residual stone group. Unenhanced computed tomography variables, including stone attenuation, abdominal fat area, and skin-to-stone distance (SSD) were analyzed. In all, 197 (60%) were classified as stone-free and 132 (40%) as having residual stone. The mean ages were 49.35 ± 13.22 years and 55.32 ± 13.52 years, respectively. On univariate analysis, age, stone size, stone surface area, stone attenuation, SSD, total fat area (TFA), abdominal circumference, serum creatinine, and the severity of hydronephrosis revealed statistical significance between these two groups. From multivariate logistic regression analysis, the independent parameters impacting SWL outcomes were stone size, stone attenuation, TFA, and serum creatinine. [Adjusted odds ratios and (95% confidence intervals): 9.49 (3.72-24.20), 2.25 (1.22-4.14), 2.20 (1.10-4.40), and 2.89 (1.35-6.21) respectively, all p < 0.05]. In the present study, stone size, stone attenuation, TFA and serum creatinine were four independent predictors for stone-free rates after SWL. These findings suggest that pretreatment NCCT may predict the outcomes after SWL. Consequently, we can use these predictors for selecting the optimal treatment for patients with urinary stones.

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“…Despite a report from Pareek et al [ 3 ] that SSD is related to successful SWL, its role has remained controversial. While some studies have confirmed that SSD is an important factor in predicting treatment outcomes [ 2 , 5 , 8 , 10 , 11 ], others have not [ 4 , 6 , 7 , 9 ]. An in vivo study by Cleveland et al [ 12 ] demonstrated that peak pressure decreases by about 30% when measured inside the body of a pig.…”

Section: Discussionmentioning

confidence: 99%

“…The increased use of computed tomography (CT) to assess urinary calculi has provided information on some stone parameters, such as mean stone density (MSD) and stone volume (SV), that could be used to predict treatment outcomes after SWL [ 1 , 2 ]. Among the various stone parameters, skin-to-stone distance (SSD) is another factor that might be able to predict the results of treatment, although its role in the prediction of treatment outcomes is still controversial [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. Because the shock wave (SW) path passes through various tissues with different compositions and densities, transmission of the SW along these different tissue planes may lead to energy loss and hence affect treatment outcome [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of renal cortical thickness on the treatment outcomes of kidney stones treated with shockwave lithotripsy

Luke

Chiu

et al. 2015

Korean J Urol

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PurposeBecause the shock wave passes through various body tissues before reaching the stone, stone composition may affect the treatment efficacy of shock wave lithotripsy (SWL). We investigated the effect of various tissue components along the shock wave path on the success of SWL.Materials and MethodsFrom October 2008 to August 2010, a total of 206 patients with kidney stones sized 5 to 20 mm were prospectively recruited for a study of the factors that affect the outcome of treatment with a Sonolith Vision lithotripter. Successful SWL was defined as either stone-free status or residual fragments <4 mm at 12 weeks. Logistic regression analysis was performed to assess the factors that predicted treatment outcomes. Potential predictors included the patient's age, shock wave delivery rate, stone volume (SV), mean stone density (MSD), skin-to-stone distance (SSD), and the mean thickness of the three main components along the shock wave path: renal cortical thickness (KT), muscle thickness (MT), and soft-tissue thickness (ST).ResultsThe mean age of the patients was 53.8 years (range, 25-82 years). The overall treatment success rate after one session of SWL was 43.2%. The mean KT, MT, and ST were 26.9, 16.6, and 40.8 mm, respectively. The logistic regression results showed that a slower shock wave delivery rate, smaller SV, a lower MSD, and a thicker KT were found to be significant predictors for successful SWL. SSD, MT, and ST were not predictors of successful treatment.ConclusionsAmong the main tissue components along the shock wave path, a thicker KT was a favorable factor for successful SWL after adjustment for SV, MSD, and the shock wave delivery rate.

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Abdominal fat distribution on computed tomography predicts ureteric calculus fragmentation by shock wave lithotripsy

Cited by 17 publications

References 28 publications

Impact of body mass index on success, complications and failure of extracorporeal shock wave lithotripsy

Impact of body mass index on success, complications and failure of extracorporeal shock wave lithotripsy

Noncontrast computed tomography can predict the outcome of shockwave lithotripsy via accurate stone measurement and abdominal fat distribution determination

The effect of renal cortical thickness on the treatment outcomes of kidney stones treated with shockwave lithotripsy

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