Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 1 de 1
Filtrar
Mais filtros

Bases de dados
Ano de publicação
Tipo de documento
Assunto da revista
País de afiliação
Intervalo de ano de publicação
1.
J Endourol ; 28(9): 1064-70, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24786613

RESUMO

PURPOSE: To evaluate the clinical efficacy, safety, and costs of percutaneous occlusive balloon catheter-assisted ureteroscopic lithotripsy (POBC-URSL) for large impacted proximal ureteral calculi. PATIENTS AND METHODS: 156 patients with impacted proximal ureteral stones ≥1.5 cm in size were randomized to ureteroscopic lithotripsy (URSL), POBC-URSL, and percutaneous nephrolithotomy (PNL) group between May 2010 and May 2013. For URSL, the calculi were disintegrated with the assistance of anti-retropulsion devices. POBC-URSL was performed with the assistance of an 8F percutaneous occlusive balloon catheter. PNL was finished with the combination of an ultrasonic and a pneumatic lithotripter. A flexible ureteroscope and a 200 µm laser fiber were used to achieve stone-free status to a large extent for each group. Variables studied were mean operative time, auxiliary procedure, postoperative hospital stay, operation-related complications, stone clearance rate, and treatment costs. RESULTS: The mean lithotripsy time for POBC-URSL was shorter than URSL, but longer than PNL (42.6±8.9 minutes vs 66.7±15.3 minutes vs 28.1±6.3 minutes, p=0.014). The auxiliary procedure rate and postoperative fever rate for POBC-URSL were significantly lower than URSL and comparable to PNL (p<0.01, p=0.034). POBC-URSL was superior to URSL with regard to the stone clearance rate at 3 days postoperatively, and as good as PNL (98.1% vs 75.0% vs 96.2%, p<0.01). The postoperative hospital stay and hematuria rate were lower in POBC-URSL group than PNL group and similar to URSL group (p=0.016, p<0.01). The treatment costs were lowest in POBC-URSL group ($1205.0±$113.9 vs $1731.7±$208.1 vs $2446.4±$166.4, p=0.004). CONCLUSIONS: For large impacted proximal ureteral calculi, POBC-URSL was associated with a higher stone clearance rate, fewer complications and costs. POBC-URSL combined the advantages of URSL and PNL.


Assuntos
Litotripsia/métodos , Nefrostomia Percutânea/métodos , Cálculos Ureterais/cirurgia , Ureteroscopia/métodos , Adulto , Análise de Variância , Oclusão com Balão/métodos , Distribuição de Qui-Quadrado , Custos e Análise de Custo , Feminino , Hematúria/etiologia , Humanos , Tempo de Internação/economia , Litotripsia/efeitos adversos , Litotripsia/economia , Litotripsia/instrumentação , Masculino , Pessoa de Meia-Idade , Nefrostomia Percutânea/efeitos adversos , Nefrostomia Percutânea/economia , Duração da Cirurgia , Estudos Prospectivos , Segurança , Resultado do Tratamento , Ultrassonografia Doppler em Cores , Cálculos Ureterais/patologia , Cálculos Ureterais/ultraestrutura , Ureteroscópios , Cateteres Urinários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA