Skin to Stone Distance Is an Independent Predictor of Stone-Free Status Following Shockwave Lithotripsy

Patel, Trushar; Kozakowski, Kristin; Hruby, Greg; Gupta, Mantu

doi:10.1089/end.2009.0394

Cited by 117 publications

(63 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[3][4][5] Importantly, these outcomes remain favorable despite stone configuration, size, location, or composition, which stands in stark contrast to other surgical modalities, namely shock wave lithotripsy. 6,7 Over the past few decades, obesity, defined as a body mass index (BMI, kg/m 2 ) greater than 30, has become increasingly prevalent, reaching epidemic proportions. 8 Given the association between obesity, metabolic syndrome, and kidney stones, 9,10 these patients commonly present with large renal stones for which PCNL is the optimal surgical treatment.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Nephrolithotomy in the Superobese: A Comparison of Outcomes Based on Body Mass Index

Dauw

Borofsky

York

et al. 2016

Journal of Endourology

View full text Add to dashboard Cite

Introduction: Percutaneous nephrolithotomy (PCNL) is considered the gold standard for treatment of large renal calculi. Although several investigators have examined the feasibility and outcomes associated with PCNL in obese patients, these studies have been limited by small sample size, lack of a comparator group, or few patients at body mass index (BMI) extremes. We thus compared outcomes of superobese (BMI >50) patients undergoing PCNL vs both an ''overweight'' and ''ideal'' cohort. Methods: We used a prospectively maintained database to identify ideal (BMI 18.5-25), overweight (BMI 25.1-49.9), and superobese (BMI ‡50) patients who underwent PCNL. Our primary objective was to compare surgical outcomes between groups measured by the percent of patients who required secondary PCNL. We then compared complication rates, need for transfusion, and length of stay (LOS) using chi-square testing and ANOVA where appropriate. Results: A total of 1152 patients were identified of which 254 were classified as ideal, 840 as overweight, and 58 as superobese. The overweight cohort had a higher mean age and greater proportion of males, whereas staghorn stones were more common in the superobese group. Comorbid conditions were more commonly observed in the superobese cohort. Otherwise, the groups were similar. Surgical outcomes were comparable with 47.2%, 42.0%, and 38.0% of ideal, overweight, and superobese patients requiring secondary PCNL ( p = 0.25) with no difference in complication rates, need for transfusion, or LOS. Conclusion: PCNL can be effectively and safely performed in superobese patients with no difference in surgical outcomes or complications when compared to ideal or overweight patient cohorts.

show abstract

Section: Introductionmentioning

confidence: 99%

Percutaneous Nephrolithotomy in the Superobese: A Comparison of Outcomes Based on Body Mass Index

Dauw

Borofsky

York

et al. 2016

Journal of Endourology

View full text Add to dashboard Cite

show abstract

“…Despite of the fact that SWL represents a highly successful non-invasive treatment in urolithiasis, several studies have demonstrated diminished efficacy in obese patients since this technique is considerably affected by skin-to-stone distances (6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Outcomes of intracorporeal lithotripsy of upper tract stones is not affected by BMI and skin-to-stone distance (SSD) in obese and morbid patients

et al. 2013

View full text Add to dashboard Cite

Purpose: The purpose of this study is to determine if body mass index (BMI) and stone skin distance (SSD) affect stone free rate (SFR) in obese and morbid obese patients who underwent flexible URS for proximal ureteral or renal stones < 20 mm. Materials and Methods: A retrospective chart review was performed of consecutive patients that underwent flexible URS. Inclusion criteria were: proximal ureteral stones and renal stones less than 20 mm in the preoperative computed tomography (CT). SFR were then compared according to SSD and BMI. Results: A total of 153 patients were eligible for this analysis, 49 (32.02%) with SSD < 10 cm and 104 (67.97%) with SSD ≥ 10 cm. The mean stone size was 10.5 ± 6.4 mm. The overall SFR in our study was 82.4%. The SFR for the SSD < 10 and ≥ 10 were 79.6% and 83.7% respectively (p = 0.698) and for BMI < 30, ≥ 30 and < 40 and ≥ 40 were 82.9%, 81.7% and 90.9% respectively. Regression analysis showed no affect between BMI or SSD regarding SFR. Conclusion: Ureteroscopy should be considered as a first-line of treatment for renal/proximal stones in obese and morbid obese patients. URS may be preferable to SWL in obese patients independently of the SSD, BMI or the location of proximal stones. INTRODuCTIONThe ideal treatment for proximal ureteral and renal stones has become controversial, with the noninvasive nature of shock wave lithotripsy (SWL) and the expansion of endoscopic digital technology. The 2007 update of the EAU/AUA ureteral stone guidelines (1) showed that both ureteroscopy (URS) and SWL should be considered first-line therapy for proximal ureteral stones, as opposed to just SWL as previously reported. On the other hand SWL has emerged as the primary treatment of choice for renal calculi less than 1.5-2 cm (2).In that context, the treatment of urolithiasis in obese patients has gained more importance in the last years since obesity rates have increased markedly since 1980 in the United States (3). Data from the national Center for Health Statistics (2009Statistics ( -2010 showed that 35.7% of adults and 17% of children and adolescents in the United States were obese (4). According to the World Health Organization guidelines, a body mass index (BMI) of 18.5 to 25 kg/m 2 is considered normal, overweight is a BMI of 25 to Outcomes of intracorporeal lithotripsy of upper tract stones is not affected by BMI and skin-to-stone distance (SSD) in obese and morbid patients _______________________________________________

show abstract

“…Так, нативная МСКТ, признанная «золотым стандар-том» в диагностике почечной колики, по точно-сти значительно превосходит внутривенную урографию, способна определять все типы кам-ней кроме индинавировых, их плотность, внут-реннюю структуру и анатомию интересующей области -все эти данные необходимы для вы-бора метода лечения [20][21][22][23][24][25].…”

unclassified

“…Таким обра-зом, только элементы с выраженной разницей в показателях Z будут различимы по их спек-тральным свойствам. Характеристиками этих различий являются: 1) Двухэнергетический индекс (ДЭИ) = (Х80-Х140)/(Х80+Х140+2000), где Х80 -плотность материала в HU при 80 kV, Х140 -плотность при 140 kV [24]. 2) Двухэнергетическое отношение (ДЭО) = (плотность материала на низкоэнергетическом изображении/плотность на высокоэнергетиче-ском изображении) [48].…”

unclassified

Application of Dual-Energy Computer Tomography in Diagnostics of Urolithiasis

Kapanadze¹,

Серова²,

Rudenko³

2017

Rejr

View full text Add to dashboard Cite

очекаменная болезнь (МКБ) -одно из наиболее распространѐнных урологи-ческих заболеваний и встречается не менее чем у 3% населения, причем наиболее часто у лиц в трудоспособном возрасте -30-50 лет. С учетом акту-альности заболевания, разработка и усовершенствование новых методов диагностики приобретают огромную социальную значимость. Ключевую роль в диагно-стике мочекаменной болезни играют лучевые методы визуализации. В настоящее время широко обсуждаются вопросы применения двухэнергетической компьютерной томо-графиии (ДЭКТ) в урологической практике. Изучение одной из главных возможностей ДЭКТ -определение состава мочевых конкрементов -продемонстрировало высокую диагностическую ценность метода. В данном научном обзоре представлены данные об особенностях применения двухэнергетической компьютерной томографии в диагности-ке мочекаменной болезни.Ключевые слова: мочекаменная болезнь, нефролитиаз, химический состав кам-ня, двухэнергетическая компьютерная томография.Контактный автор: Капанадзе Л.Б., e-mail: Lidakap@rambler.ru 165-173. DOI:10.21569/2222165-173. DOI:10.21569/ -7415-2017 Для цитирования: Капанадзе Л.Б., Серова Н.С., Руденко В.И. Аспекты примене-ния двухэнергетической компьютерной томографии в диагностике мочекаменной бо-лезни. REJR 2017; 7(3): APPLICATION OF DUAL-ENERGY COMPUTER TOMOGRAPHY IN DIAGNOSTICS OF UROLITHIASISKapanadze L.B., Serova N.S., Rudenko V.I.rolithiasis is one of the most common urological diseases. It occurs in more than 3% of the population and most often among people of working age -30-50 years old. Taking into account the urgency of the disease, the development and improvement of new diagnostics methods become of great social importance. Radiology has key role in the diagnosis of urolithiasis. Currently, questions of dual-energy computed tomography (DECT) application in urological practice are widely discussed. The study of one of the main features of DECT -the determination of the urinary stones composition -demonstrated high diagnostic value of the method. This scientific review presents data on the features of the DECT usage in the urolithiasis diagnosis.

show abstract

Skin to Stone Distance Is an Independent Predictor of Stone-Free Status Following Shockwave Lithotripsy

Abstract: SSD is an easily measured parameter on NCCT that independently correlates with SWL efficacy in treating stones in all locations.

Cited by 117 publications

References 13 publications

Percutaneous Nephrolithotomy in the Superobese: A Comparison of Outcomes Based on Body Mass Index

Percutaneous Nephrolithotomy in the Superobese: A Comparison of Outcomes Based on Body Mass Index

Outcomes of intracorporeal lithotripsy of upper tract stones is not affected by BMI and skin-to-stone distance (SSD) in obese and morbid patients

Application of Dual-Energy Computer Tomography in Diagnostics of Urolithiasis

Contact Info

Product

Resources

About