Vestnik Urologii (Dec 2020)
Efficiency of the contact antegrade electro-pulse lithotripsy in the kidney stones treatment
Abstract
Introduction. There remains a need to introduce new methods of treating kidney stones, given the increasing incidence of urolithiasis. Considering the proven efficacy and safety of retrograde electro-pulse lithotripsy, its use in the treatment of stones in the ureter, kidney and bladder, the need to expand the scope of this method is substantiated. Namely, the use in the treatment of kidney stones and the ureteropelvic junction with percutaneous approach.Purpose of the study. Assessment of the destruction effectiveness of kidney stones using an electro-pulse lithotripsy apparatus through antegrade (percutaneous) approach.Materials and methods. 229 percutaneous nephrolithotripsies were performed in patients with different locations of kidney stones in Siberian State Medical University Clinics (Tomsk, Russia) period from 2014 to 2019. We used the Urolit-105M electro-pulse lithotripter (Lithotech Medical, Israel, MedLine LLC, Russia) or the Calculase II laser lithotripter in some cases (Storz, Germany).Results. Patients were aged from 24 to 81 (women - 59.8%). The stones average size was 22 mm (from 10 to 73 mm). The stones average density was 1051.1 HU (from 360 to 1720 HU). The operation average duration was 122.3 minutes (from 40 to 300 minutes). The incidence of complications was 14.3%. The complete stones destruction occurred in 76% cases and that in combination with the laser went up to 89.95%. The overall response rate in redo operations reached 98.2%.Conclusion. Application of the electro-pulse method of kidney stone destruction with the percutaneous approach is makes a great effect, which is much higher when the stones is treated by the laser energy. Furthermore, combing with flexible endoscopes enables to apply the electro-pulse lithotripsy antegradely in hard-to-reach spots of the kidney cavitary system with no extra access to be provided. The method also enables to fight efficiently with the ureter upper part stones, also in combination with the retrograde approach to the stones.
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