Extracorporeal shock wave lithotripsy of urinary calculi. Theory, efficacy, and adverse effects.
AUTOR(ES)
Kelley, J. M.
RESUMO
Extracorporeal shock wave lithotripsy (ESWL) for the treatment of upper urinary tract stone disease is held in high regard by the public and the profession. Although the efficacy is good (77.4% to 100%) for the treatment of 1- to 2-cm stones in select patients, ESWL may require the assistance of adjuvant procedures in as many as 26% of patients and may need repeating in as many as 32% of patients. These represent more difficult situations in which larger, more numerous, or harder stones may be present and in which ureteral stones are manipulated before treatment. The predominant adverse effect of ESWL treatment is the microvascular disruption of the tissues through which the shock waves pass. In addition, the procedure is painful, with many patients requiring narcotic analgesia. Long-term complications such as the new onset of hypertension have occurred in as many as 8% of treated patients, but much speculation about the long-term effects remains.
ACESSO AO ARTIGO
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1002469Documentos Relacionados
- A meta-analysis of the efficacy of ureteroscopic lithotripsy and extracorporeal shock wave lithotripsy on ureteral calculi
- Book Review: Principles of Extracorporeal Shock Wave Lithotripsy
- Extracorporeal shock-wave lithotripsy with minimal or no anesthesia.
- Infected hepatic hematoma after renal extracorporeal shock wave lithotripsy
- Extracorporeal shockwave lithotripsy versus ureteroscopy for distal ureteric calculi: efficacy and patient satisfaction