The lithotripsy table height: a novel predictor of outcome in shockwave lithotripsy.
Int Braz J Urol
; 37(3): 355-61; discussion 361, 2011.
Article
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| MEDLINE
| ID: mdl-21756383
ABSTRACT
BACKGROUND:
Outcome of Extracorporeal Shockwave Lithotripsy (SWL) is determined by physical factors that affect stone fragmentation and clearance.PURPOSE:
To evaluate the predictive value of the Lithotripsy Table Height (LTH) in SWL outcome. Lithotripsy Table Height (LTH) is a variable that represents skin to therapy head distance, and it is proportional to the energy that reaches the stone. MATERIALS ANDMETHODS:
A prospective study enrolled patients undergoing SWL for radiopaque urinary stones. All procedures were performed using a Modulith SLX (Karl Storz, Germany) Lithotripter. Patient weight, height and age; stone location and size; number of shock waves delivered, and LTH were recorded. One month post-procedure a KUB was obtained. Logistic regression analysis was used to evaluate the effects of these variables on stone-free outcome. A ROC curve was plotted.RESULTS:
Fifty-six patients were enrolled. After one month follow-up, overall success rate (Stone Free) was 83.9% (n = 47). LTH was the only independent predictor of outcome in both univariate and multivariate analysis (p = 0.029). Stone size (p = 0.45) and BMI (p = 0.32) were not significant. In the ROC curve, LTH showed an Area under the Curve = 0.791. Patients with LTH < 218 (n = 8) had relative risk of residual stones = 7.5, odds Ratio 6.6 (Stone free rate 37.5% vs. 91.5%).CONCLUSION:
LTH appears to be an independent predictor of SWL outcome. High success rates can be expected if LTH > 218. Patients with lower LTH had a less effective therapy, therefore, worse stone fragmentation and clearance. These findings may help improve patient selection for SWL therapy.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Litotricia
/
Cálculos Urinarios
/
Mesas de Operaciones
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do sul
/
Chile
Idioma:
En
Revista:
Int Braz J Urol
Asunto de la revista:
UROLOGIA
Año:
2011
Tipo del documento:
Article
País de afiliación:
Chile