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1555 COMPARATIVE ANALYSIS OF ANTERIOR AND POSTERIOR TREATMENT PLANES UTILIZING THE DORNIER DELTA COMPACT ELECTROMAGNETIC LITHOTRIPTER

2011; Lippincott Williams & Wilkins; Volume: 185; Issue: 4S Linguagem: Inglês

10.1016/j.juro.2011.02.1563

1527-3792

Brent Hardin, Adam F. Stewart, John Beddies, R.C. Pickens, Wesley M. White, W. Bedford Waters, Frederick A. Klein,

Kidney Stones and Urolithiasis Treatments

You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal1 Apr 20111555 COMPARATIVE ANALYSIS OF ANTERIOR AND POSTERIOR TREATMENT PLANES UTILIZING THE DORNIER DELTA COMPACT ELECTROMAGNETIC LITHOTRIPTER Brent Hardin, Adam Stewart, John Beddies, Ryan Pickens, Wesley White, W. Bedford Waters, and Frederick Klein Brent HardinBrent Hardin Knoxville, TN More articles by this author , Adam StewartAdam Stewart Knoxville, TN More articles by this author , John BeddiesJohn Beddies Knoxville, TN More articles by this author , Ryan PickensRyan Pickens Knoxville, TN More articles by this author , Wesley WhiteWesley White Knoxville, TN More articles by this author , W. Bedford WatersW. Bedford Waters Knoxville, TN More articles by this author , and Frederick KleinFrederick Klein Knoxville, TN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1563AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Extracorporeal shockwave lithotripsy (ESWL) has been shown to be a safe and effective modality for the treatment of renal and upper ureteral calculi. Proper treatment of calculi requires visualization and localization of stones via two-dimensional fluoroscopy. In certain cases, stone position and patient body habitus prohibit stone localization in the posterior plane. In these circumstances, the patient must be repositioned prone or an alternate treatment modality must be investigated. A few lithotripters allow for rotation of the treatment head for localization of the calculus in the anterior plane. Limited data exists concerning efficacy and complications of the anterior treatment approach. We present longitudinal data comparing the safety and efficacy of these two approaches from a large cohort of patients treated by our regional stone center. METHODS Data was obtained by a retrospective review of all after care reports from the database of patients treated on a Dornier delta compact lithotripter with rotating treatment head. Parameters such as stone location, stone size, and treatment approach were reviewed. Outcomes were determined and compared for each treatment group including rates of success and post-treatment adverse events. RESULTS Between 1/1/2000 and 12/31/2009, 14,313 patients underwent 22,463 treatments for renal or ureteral calculi by ESWL. Mean stone size was 9.04 mm. A total of 20,810 stones (79.5%) were treated with a posterior approach and 5,363 stones (20.5%) were treated via an anterior approach. Success rates were 91% and 89% from the posterior and anterior approaches, respectively. Rates of hematoma formation were 0.3% and 0.1% for posterior and anterior approaches, respectively. The rate of post-operative obstruction was 1.0% and the hospital admission rate post-operatively was 0.68% for the entire cohort. Four Clavien grade 4–5 complications occurred in the entire cohort, all of which were treated in the posterior position. CONCLUSIONS Based on observational, non-randomized data, the anterior approach appears to offer comparable results to posterior treatments in terms of efficacy and safety. Lithotripters with a rotational head offer safety and convenience to the patient and staff by facilitating anterior treatment positions without changing patient position. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e624 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Brent Hardin Knoxville, TN More articles by this author Adam Stewart Knoxville, TN More articles by this author John Beddies Knoxville, TN More articles by this author Ryan Pickens Knoxville, TN More articles by this author Wesley White Knoxville, TN More articles by this author W. Bedford Waters Knoxville, TN More articles by this author Frederick Klein Knoxville, TN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...