grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2023-182-6-27-31grekov-2362Research ArticleОПЫТ РАБОТЫEXPERIENCE OF WORKСравнение экстракорпоральной ударно-волновой литотрипсии и уретероскопической лазерной литотрипсии при камнях проксимального отдела мочеточника размером от 10 до 20 мм: одноцентровый опытExtracorporeal Shockwave Lithotripsy versus Ureteroscopic Laser Lithotripsy in Proximal Ureteric Calculus of 10 to 20 mm in Size: A single centre experiencePushpanathanM.PushpanathanM.

Mugialan Pushpanathan, Hospital Sultan Abdul Aziz Shah

 

Mugialan Pushpanathan

drmugialan@gmail.comFahmyO. A.FahmyO. A.

Omar Ahmed Fahmy Ahmed

Level 4, Block B, FPSK 43400 UPM Serdang. 6

Omar Ahmed Fahmy Ahmed

Level 4, Block B, FPSK 43400 UPM Serdang

docomar82@gmail.comLeeCKSLeeCKS

Christoper Lee Kheng Siang

 

Christoper Lee Kheng Siang

chriskslee2@gmail.comKhairul-AsriM. G.Khairul-AsriM. G.

Khairul Asri Mohd Ghani, Urology, Robotic Surgery

Khairul Asri Mohd Ghani, Urology, Robotic Surgery

khairulasri@gmail.comDepartment of Urology, Hospital Sultan Abdul Aziz Shah, University Putra MalaysiaМалайзияDepartment of Urology, Hospital Sultan Abdul Aziz Shah, University Putra MalaysiaMalaysiaDepartment of Urology, Faculty of Medicine and Health Sciences, University Putra MalaysiaМалайзияDepartment of Urology, Faculty of Medicine and Health Sciences, University Putra MalaysiaMalaysia20231704202418262731Copyright © Pushpanathan M., Fahmy O.A., Lee C., Khairul-Asri M.G., 20242024Pushpanathan M., Fahmy O.A., Lee C., Khairul-Asri M.G.Pushpanathan M., Fahmy O.A., Lee C., Khairul-Asri M.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/2362

ЦЕЛЬ. Изучить эффективность экстракорпоральной ударно-волновой литотрипсии (ЭУВЛ) и уретероскопической лазерной литотрипсии (УРС ЛЛ) при лечении камней верхнего отдела мочеточника размером от 10 до 20 мм. С января 2020 по январь 2023 г. 75 пациентов прошли лечение по поводу камней в проксимальном отделе мочеточника с использованием ЭУВЛ (n=40) и УРС ЛЛ (n=35).МЕТОДЫ И МАТЕРИАЛЫ. Обе группы пациентов, прошедшие лечение по поводу камней проксимального отдела мочеточника диаметром 10-20 мм, сравнивали по времени операции, частоте успешности и осложнениям. В группе УРС ЛЛ наблюдалась более высокая частота полного освобождения от камней по сравнению с группой ЭУВЛ, 31 (88,6 %) пациент против 20 (50,0 %) (р<0,001).РЕЗКЛЬТАТЫ. УРС ЛЛ сопровождалась более высокой частотой осложнений по сравнению с ЭУВЛ, 9 (25,7 %) против 3 (7,5 %); (р=0,032). Время выполнения УРС ЛЛ было больше по сравнению с ЭУВЛ, медиана (IQR) для УРС ЛЛ и ЭУВЛ составила 78,0 (65,0; 100,0) против 62,0 (48,0; 67,0) мин (p<0,001).ЗАКЛЮЧЕНИЕ. Мы пришли к выводу, что по сравнению с однократным сеансом ЭУВЛ у УРС ЛЛ более высокая частота полного освобождения от камней в верхнем отделе мочеточника диаметром 10-20 мм, большая частота осложнений, таких как послеоперационная лихорадка и боль.

OBJECTIVE

OBJECTIVE. To investigate the efficacy of extracorporeal shockwave lithotripsy (ESWL) and ureteroscopic laser lithotripsy (URS) treatment of upper ureteric stones between 10 to 20 mm in size. From January 2020 to January 2023, 75 patients were treated for proximal ureteric calculus between using ESWL (n=40) & URS (n=35).

METHODS AND MATERIALS

METHODS AND MATERIALS. Both groups were compared regarding operative time, success rate and complications who underwent treatment for proximal ureteric calculus of 10–20 mm in diameter. URS group was observed to have higher stone-free rate, compared to the ESWL group, 31 (88.6 %) vs 20 patients (50.0 %) (p<0.001).

RESULTS

RESULTS. URS treatment had a higher complication rate compared to the ESWL, 9 (25.7 %) vs 3(7.5 %) ;( p=0.032). Procedure time for URS was longer, compared to the ESWL, median (IQR) for URS vs ESWL were 78.0 (65.0, 100.0) vs 62.0 (48.0, 67.0) minutes; (p<0.001).

CONCLUSION

CONCLUSION. We conclude that URS has a better stone-free rate in comparison to a single session of ESWL for upper ureteral calculus of 10–20 mm, with higher complication rates such as post-operative fever and pain.

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The authors declare that there are no conflicts of interest present.