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VARIATION IN CLINICAL OUTCOME FOLLOWING SHOCK WAVE LITHOTRIPSY

2000; Lippincott Williams & Wilkins; Volume: 163; Issue: 3 Linguagem: Inglês

10.1016/s0022-5347(05)67791-9

1527-3792

NICK F. LOGARAKIS, Michael A.S. Jewett, JACQUELINE J. LUYMES, R. John D’A. Honey,

Radiation Dose and Imaging

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Mar 2000VARIATION IN CLINICAL OUTCOME FOLLOWING SHOCK WAVE LITHOTRIPSY NICK F. LOGARAKIS, MICHAEL A.S. JEWETT, J. LUYMES, and R. JOHN D’A. HONEY NICK F. LOGARAKISNICK F. LOGARAKIS More articles by this author , MICHAEL A.S. JEWETTMICHAEL A.S. JEWETT More articles by this author , J. LUYMESJ. LUYMES More articles by this author , and R. JOHN D’A. HONEYR. JOHN D’A. HONEY More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67791-9AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We measure and compare operator specific success rates of extracorporeal shock wave lithotripsy (ESWL * Dornier Medical Systems, Inc., Marietta, Georgia. ) performed by 12 urologists in 1 unit to determine interoperator variation. Materials and Methods: From January 1, 1994 to September 1, 1997 a total of 5,769 renal and ureteral stones received 9,607 ESWL treatments by 15 urologists with a Dornier MFL 5000* lithotriptor. The 3-month followup data are available for 4,409 stones. Outcome measures consisted of patient demographics, stone characteristics, technical details of lithotripsy, and stone-free and success rates by treating urologists. Results: Treatment results were analyzed for 12 urologists (surgeons A to L) who treated more than 100 stones each, totaling 4,244 with followup information available. Mean stone-free and success rates were 50.6% and 72.3%, respectively. Surgeon A had significantly higher stone-free and success rates of 56.2% and 76.7%, respectively (p <0.05), with treatment results from 877 stones, which was a significantly higher number than others (p <0.05). Significant differences existed in mean number of shocks delivered among urologists (p = 0.0001), with surgeons A and J delivering the highest mean numbers (2,317 and 2,801, respectively). There was no difference in treatment duration (p = 0.75) but variation existed among urologists in terms of mean maximum treatment voltage (p = 0.0001). Mean fluoroscopy time at 4.1 minutes was higher for surgeon A than others (p <0.05). Mean complication rate following ESWL was 4.9% with no difference among urologists (p = 0.175). Re-treatment was required in 21.7% of cases and surgeon A had the lowest rate (15.9%, p <0.05). Conclusions: We demonstrated clinically and statistically significant intra-institutional differences in success rates following ESWL. The best results were obtained by the urologist who treated the greatest number of patients, used a high number of shocks and had the longest fluoroscopy time. 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Google Scholar From the Urolithiasis Program, Division of Urology, The University of Toronto, Toronto, Ontario, Canada© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byAssimos D (2018) Re: Renal Haemorrhage Risk After Extracorporeal Shockwave Lithotripsy: Results from the Japanese Diagnosis Procedure Combination DatabaseJournal of Urology, VOL. 188, NO. 3, (848-849), Online publication date: 1-Sep-2012.Sun X, He L, Lu J, Cong X, Shen L, Wang Y and Zhu H (2018) Greater and Lesser Ischiadic Foramina as Path of Shock Wave Lithotripsy for Distal Ureteral Stone in ChildrenJournal of Urology, VOL. 184, NO. 2, (665-668), Online publication date: 1-Aug-2010.Perks A, Gotto G and Teichman J (2018) Shock Wave Lithotripsy Correlates With Stone Density on Preoperative Computerized TomographyJournal of Urology, VOL. 178, NO. 3, (912-915), Online publication date: 1-Sep-2007.WU C, SHEE J, LIN W, LIN C and CHEN C (2018) COMPARISON BETWEEN EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY AND SEMIRIGID URETERORENOSCOPE WITH HOLMIUM: YAG LASER LITHOTRIPSY FOR TREATING LARGE PROXIMAL URETERAL STONESJournal of Urology, VOL. 172, NO. 5, (1899-1902), Online publication date: 1-Nov-2004.SHEIR K, MADBOULY K and ELSOBKY E (2018) Prospective Randomized Comparative Study of the Effectiveness and Safety of Electrohydraulic and Electromagnetic Extracorporeal Shock Wave LithotriptorsJournal of Urology, VOL. 170, NO. 2, (389-392), Online publication date: 1-Aug-2003.WILLIAMS J, PATERSON R, KOPECKY K, LINGEMAN J and McATEER J (2018) HIGH RESOLUTION DETECTION OF INTERNAL STRUCTURE OF RENAL CALCULI BY HELICAL COMPUTERIZED TOMOGRAPHYJournal of Urology, VOL. 167, NO. 1, (322-326), Online publication date: 1-Jan-2002.Loening S (2018) EDITORIAL: WHAT TO DO WITH ALL THE TOOLS? IS LESS MORE OR MORE LESS?Journal of Urology, VOL. 164, NO. 3 Part 1, (651-651), Online publication date: 1-Sep-2000. Volume 163Issue 3March 2000Page: 721-725 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordscomparative studykidney calculilithotripsytreatment outcomebenchmarkingMetricsAuthor Information NICK F. LOGARAKIS More articles by this author MICHAEL A.S. JEWETT More articles by this author J. LUYMES More articles by this author R. JOHN D’A. HONEY More articles by this author Expand All Advertisement PDF downloadLoading ...