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Pediatrik Ürolitiyazis Tedavisinde Beden Dışı Şok Dalga Litotripsi (ESWL) Sonuçlarımız: Tek Merkez Deneyimi

Year 2021, Volume: 18 Issue: 1, 18 - 23, 28.04.2021
https://doi.org/10.35440/hutfd.890317

Abstract

Amaç:Bu çalışmadaamacımız ürolitiyazis nedeniyle ESWL uyguladığımız çocukların tedavi sonuçlarını değerlendirmektir.
Materyal ve metod:Ekim 2018–Ekim 2020 tarihleri arasında anestezi altında ESWL uygulanan çocukların kayıtları retrospektif olarak incelendi. Hastalar ESWL başarısına göre iki gruba ayrılarak yaş, cinsiyet, taş boyutu, taş lokalizasyonu, komplikasyonlar ve ek müdahaleler açısından karşılaştırıldı.
Bulgular:Çalışmaya dahil edilen 50 olgunun 34(%68)’ü erkek, 16(%32)’sı kız idi. Hastaların ortalama yaşı8,8±5,0yıl idi. Taşların 29’u sağ, 21’i sol taraftaydı. Taşların 36’sı böbrek, 14’ü ise proksimal üreter yerleşimliydi.ESWL başarılı grupta taş boyutu ortalama 9.4±1.8 mm, başarısız grupta ise 13.8±3.2 mm olarak saptandı(p<0.05).10mm’nin altındaki taşlarda ESWL başarısı %90 iken, 10mm üzerindeki taşlarda %56.7 olarak bulundu(p<0,05). Toplam başarı % 70 idi. Yaş, cinsiyet, taşların tarafı ve lokalizasyonları ile ESWL başarısı arasında anlamlı bir ilişki bulunmadı(p>0,05). İki hastada taş yolu, 1 hastada üriner enfeksiyon ve 5 hastada geçici hematüri görüldü.
Sonuç:Ürolitiyazisli çocuklarda ESWL etkili ve güvenli bir tedavi yöntemidir. Taş boyutu başarıyı etkileyen önemli bir faktördür. Özellikle ≥10 mm taşlarda, seans başına maksimum yararlanmayı sağlayacak ve başarısız bir uygulamanın önüne geçebilecek öngörüyü ortaya çıkaracak çalışmalara ihtiyaç vardır.

Supporting Institution

Yok

Thanks

Kliniğimizin ESWL ünitesinde uzun yıllardır görev yapan Mahmut Gazi ŞAŞMAZ' a verdiği hizmetlerden dolayı teşekkürlerimizi sunuyoruz.

References

  • 1. Muslumanoglu AY, Binbay M, Yuruk E, Akman T, Tepeler A, Esen T, et al. Updated epidemiologic study of urolithiasis in Turkey. I: Changing characteristics of urolithiasis. Urological Research. 2011; 39(4):309–314.
  • 2. Ansari MS, Gupta NP, Hemal AK, Dogra PN, Seth A, Aron M, et al. Spectrum of stone composition: structural analysis of 1050 upper urinary tract calculi from northern India. Int J Urol. 2005; 12(1):12-6.
  • 3. Sharma AP, Filler G. Epidemiology of pediatric urolithiasis. Indian J Urol. 2010; 26(4):516-22.
  • 4. Clayton DB, Pope JC. The increasing pediatric stone disease problem. Ther Adv Urol. 2011; 3(1):3-12.
  • 5. Destro F, Selvaggio GGO, Lima M, Riccipetitoni G, Klersy C, Di Salvo N, et al. Minimally Invasive Approaches in Pediatric Urolithiasis. The Experience of Two Italian Centers of Pediatric Surgery. Front Pediatr. 2020; 24: 8:377.
  • 6. Newman DM, Coury T, Lingeman JE, Mertz JH, Mosbaugh PG, Steele RE, et al. Extracorporeal shock wave lithotripsy experience in children. J Urol. 1986; 136(1 Pt 2):238-40.
  • 7. Özçakır E, Özçakır L, Kaçar M, Altındağ T, Erdoğan H, Durmaz O, et al. Çocuklarda üriner sistem taş hastalığı tedavisinde ESWL deneyimlerimiz. Çocuk Cerrahisi Dergisi. 2010; 24:12-17.
  • 8. Demir M, Dere O, Yağmur İ, Katı B, Pelit ES, Albayrak İH, et al. Usability of shear wave elastography to predict the success of extracorporeal shock-wave lithotripsy: prospective pilot study. Urolithiasis. 2020; 26:1-6.
  • 9. Lee HY, Yang YH, Lee YL, Shen JT, Jang MY, Shih PM, et al. Noncontrast computed tomography factors that predict the renal stone outcome after shock wave lithotripsy. Clin Imaging. 2015; 39(5):845-50.
  • 10. Grivas N, Thomas K, Drake T, Donaldson J, Neisius A, Petřík A, et al. Imaging modalities and treatment of paediatric upper tract urolithiasis: A systematic review and update on behalf of the EAU urolithiasis guidelines panel. J Pediatr Urol. 2020; 16(5):612-624.
  • 11. Dogan HS, Altan M, Citamak B, Bozaci AC, Karabulut E, Tekgul S. A new nomogram for prediction of outcome of pediatric shock-wave lithotripsy. J Pediatr Urol. 2015; 11. 84.e1-6.
  • 12. Osman Ergün. Beden Dışı Şok Dalga ile Taş Kırma Tedavisinin Başarı ve Sonucu Üzerine Etkili Faktörler. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2018; 9.2: 54-57.
  • 13. Gültekin MH, Türegün FA, Önal B. ESWL: Henüz Ölmedi, Başarı Oranlarını Arttırabiliriz? Endoüroloji Bülteni. 2015; 8:72-74.
  • 14. Shouman AM, Ghoneim IA, ElShenoufy A, Ziada AM. Safety of ungated shockwave lithotripsy in pediatric patients. J Pediatr Urol. 2009; 5(2):119-21.
  • 15. Kati B, Pelit ES, Yagmur I, Sagir S, Ciftci H, Yeni E. Effects of the distance between renal calculi and skin and the body mass index on the success of ESWL among renal calculi patients. JOJ Urol Nephrol. 2017; 3, 3.
  • 16. Yılmaz Aksoy, Turgut Yapanoğlu. Çocukluk Taş Hastalığında Extracorporeal Shock Wave Lıthotrıpsy: Hala Yaşıyor ve Çok Etkili. Endoüroloji Bülteni. 2016; 9:10-13.
  • 17. El-Sheemy MS, Daw K, Habib E, Aboulela W, Fathy H, Shouman AM, et al. Lower calyceal and renal pelvic stones in preschool children: a comparative study of minipercutaneous nephrolithotomy versus extracorporeal shockwave lithotripsy. Int J Urol. 2016; 23:564e70.
  • 18. Badawy AA, Saleem MD, Abolyosr A, Aldahshoury M, Elbadry MS, Abdalla MA, et al. Extracorporeal shock wave lithotripsy as first line treatment for urinary tract stones in children: outcome of 500 cases. Int Urol Nephrol. 2012; 44: 661e6.
  • 19. Alsagheer G, Abdel-Kader MS, Hasan AM, Mahmoud O, Mohamed O, Fathi A, et al. Extracorporeal shock wave lithotripsy (ESWL) monotherapy in children: predictors of successful outcome. J Pediatr Urol. 2017; 13. 515.e1-515.e5.
  • 20. Kızılay F, Özdemir T, Turna B, Karaca N, Şimşir A, Alper I, et al. Factors affecting the success of pediatric extracorporeal shock wave lithotripsy therapy: 26-year experience at a single institution. Turk J Pediatr. 2020; 62(1):68-79.
  • 21. Lu J, Sun X, He L, Wang Y. Efficacy of extracorporeal shock wave lithotripsy for ureteral stones in children. Pediatr Surg Int. 2009; 25(12):1109-12.
  • 22. Dretler SP. Stone fragility: a new therapeutic distinction. J Urol. 1988; 139(5):1124-7.
  • 23. Massoud AM, Abdelbary AM, Al-Dessoukey AA, Moussa AS, Zayed AS, Mahmmoud O. The success of extracorporeal shock-wave lithotripsy based on the stone-attenuation value from non-contrast computed tomography. Arab J Urol. 2014; 12(2):155-61.
  • 24. Silay MS, Ellison JS, Tailly T, Caione P. Update on Urinary Stones in Children: Current and Future Concepts in Surgical Treatment and Shockwave Lithotripsy. Eur Urol Focus. 2017; 3(2-3):164-171.
  • 25. D'Addessi A, Bongiovanni L, Sasso F, Gulino G, Falabella R, Bassi P. Extracorporeal shockwave lithotripsy in pediatrics. J Endourol. 2008; 22(1):1-12.
  • 26. Lao M, Kogan BA, White MD, Feustel PJ. High recurrence rate at 5-year followup in children after upper urinary tract stone surgery. J Urol. 2014; 191(2):440-4.

The Results of Extracorporeal Shock Wave Lithotripsy (ESWL) in Pediatric Urolithiasis Treatment: A Single Center Experience

Year 2021, Volume: 18 Issue: 1, 18 - 23, 28.04.2021
https://doi.org/10.35440/hutfd.890317

Abstract

Background: Our aim is to evaluate the treatment results of children who underwent ESWL for urolithiasis
Materials and Methods: Records of children who underwent ESWL between October 2018 and October 2020 were retrospectively reviewed. The patients were divided into two groups according to success and compared in terms of age, gender, stone size, stone location, complications, and additional interventions.
Results: Of the 50 cases, 34(68%) were boys and 16(32%) were girls. The mean age was 8.8 ± 5.0 years. 36 of the stones were located in the kidney and 14 were in the proximal ureter. The average stone size was 9.4±1.8 mm in the successful ESWL group and 13.8±3.2 mm in the unsuccessful group (p <0.05). While the success was 90% for stones less than 10 mm, it was found to be 56.7% for stones over 10 mm (p <0.05). Total success was 70%. There was no significant correlation between age, gender, side and localization of stones and ESWL success (p> 0.05).
Conclusion: ESWL is an effective and safe treatment method for children with urolithiasis. Stone size is an important factor affecting success. Especially for stones ≥10 mm, there is a need for studies that will provide the maximum benefit per session and reveal the predictions that can prevent an unsuccessful application.

References

  • 1. Muslumanoglu AY, Binbay M, Yuruk E, Akman T, Tepeler A, Esen T, et al. Updated epidemiologic study of urolithiasis in Turkey. I: Changing characteristics of urolithiasis. Urological Research. 2011; 39(4):309–314.
  • 2. Ansari MS, Gupta NP, Hemal AK, Dogra PN, Seth A, Aron M, et al. Spectrum of stone composition: structural analysis of 1050 upper urinary tract calculi from northern India. Int J Urol. 2005; 12(1):12-6.
  • 3. Sharma AP, Filler G. Epidemiology of pediatric urolithiasis. Indian J Urol. 2010; 26(4):516-22.
  • 4. Clayton DB, Pope JC. The increasing pediatric stone disease problem. Ther Adv Urol. 2011; 3(1):3-12.
  • 5. Destro F, Selvaggio GGO, Lima M, Riccipetitoni G, Klersy C, Di Salvo N, et al. Minimally Invasive Approaches in Pediatric Urolithiasis. The Experience of Two Italian Centers of Pediatric Surgery. Front Pediatr. 2020; 24: 8:377.
  • 6. Newman DM, Coury T, Lingeman JE, Mertz JH, Mosbaugh PG, Steele RE, et al. Extracorporeal shock wave lithotripsy experience in children. J Urol. 1986; 136(1 Pt 2):238-40.
  • 7. Özçakır E, Özçakır L, Kaçar M, Altındağ T, Erdoğan H, Durmaz O, et al. Çocuklarda üriner sistem taş hastalığı tedavisinde ESWL deneyimlerimiz. Çocuk Cerrahisi Dergisi. 2010; 24:12-17.
  • 8. Demir M, Dere O, Yağmur İ, Katı B, Pelit ES, Albayrak İH, et al. Usability of shear wave elastography to predict the success of extracorporeal shock-wave lithotripsy: prospective pilot study. Urolithiasis. 2020; 26:1-6.
  • 9. Lee HY, Yang YH, Lee YL, Shen JT, Jang MY, Shih PM, et al. Noncontrast computed tomography factors that predict the renal stone outcome after shock wave lithotripsy. Clin Imaging. 2015; 39(5):845-50.
  • 10. Grivas N, Thomas K, Drake T, Donaldson J, Neisius A, Petřík A, et al. Imaging modalities and treatment of paediatric upper tract urolithiasis: A systematic review and update on behalf of the EAU urolithiasis guidelines panel. J Pediatr Urol. 2020; 16(5):612-624.
  • 11. Dogan HS, Altan M, Citamak B, Bozaci AC, Karabulut E, Tekgul S. A new nomogram for prediction of outcome of pediatric shock-wave lithotripsy. J Pediatr Urol. 2015; 11. 84.e1-6.
  • 12. Osman Ergün. Beden Dışı Şok Dalga ile Taş Kırma Tedavisinin Başarı ve Sonucu Üzerine Etkili Faktörler. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2018; 9.2: 54-57.
  • 13. Gültekin MH, Türegün FA, Önal B. ESWL: Henüz Ölmedi, Başarı Oranlarını Arttırabiliriz? Endoüroloji Bülteni. 2015; 8:72-74.
  • 14. Shouman AM, Ghoneim IA, ElShenoufy A, Ziada AM. Safety of ungated shockwave lithotripsy in pediatric patients. J Pediatr Urol. 2009; 5(2):119-21.
  • 15. Kati B, Pelit ES, Yagmur I, Sagir S, Ciftci H, Yeni E. Effects of the distance between renal calculi and skin and the body mass index on the success of ESWL among renal calculi patients. JOJ Urol Nephrol. 2017; 3, 3.
  • 16. Yılmaz Aksoy, Turgut Yapanoğlu. Çocukluk Taş Hastalığında Extracorporeal Shock Wave Lıthotrıpsy: Hala Yaşıyor ve Çok Etkili. Endoüroloji Bülteni. 2016; 9:10-13.
  • 17. El-Sheemy MS, Daw K, Habib E, Aboulela W, Fathy H, Shouman AM, et al. Lower calyceal and renal pelvic stones in preschool children: a comparative study of minipercutaneous nephrolithotomy versus extracorporeal shockwave lithotripsy. Int J Urol. 2016; 23:564e70.
  • 18. Badawy AA, Saleem MD, Abolyosr A, Aldahshoury M, Elbadry MS, Abdalla MA, et al. Extracorporeal shock wave lithotripsy as first line treatment for urinary tract stones in children: outcome of 500 cases. Int Urol Nephrol. 2012; 44: 661e6.
  • 19. Alsagheer G, Abdel-Kader MS, Hasan AM, Mahmoud O, Mohamed O, Fathi A, et al. Extracorporeal shock wave lithotripsy (ESWL) monotherapy in children: predictors of successful outcome. J Pediatr Urol. 2017; 13. 515.e1-515.e5.
  • 20. Kızılay F, Özdemir T, Turna B, Karaca N, Şimşir A, Alper I, et al. Factors affecting the success of pediatric extracorporeal shock wave lithotripsy therapy: 26-year experience at a single institution. Turk J Pediatr. 2020; 62(1):68-79.
  • 21. Lu J, Sun X, He L, Wang Y. Efficacy of extracorporeal shock wave lithotripsy for ureteral stones in children. Pediatr Surg Int. 2009; 25(12):1109-12.
  • 22. Dretler SP. Stone fragility: a new therapeutic distinction. J Urol. 1988; 139(5):1124-7.
  • 23. Massoud AM, Abdelbary AM, Al-Dessoukey AA, Moussa AS, Zayed AS, Mahmmoud O. The success of extracorporeal shock-wave lithotripsy based on the stone-attenuation value from non-contrast computed tomography. Arab J Urol. 2014; 12(2):155-61.
  • 24. Silay MS, Ellison JS, Tailly T, Caione P. Update on Urinary Stones in Children: Current and Future Concepts in Surgical Treatment and Shockwave Lithotripsy. Eur Urol Focus. 2017; 3(2-3):164-171.
  • 25. D'Addessi A, Bongiovanni L, Sasso F, Gulino G, Falabella R, Bassi P. Extracorporeal shockwave lithotripsy in pediatrics. J Endourol. 2008; 22(1):1-12.
  • 26. Lao M, Kogan BA, White MD, Feustel PJ. High recurrence rate at 5-year followup in children after upper urinary tract stone surgery. J Urol. 2014; 191(2):440-4.
There are 26 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

İsmail Yağmur 0000-0002-4208-5095

Mehmet Demir 0000-0002-3618-0547

Bülent Katı 0000-0002-4024-5147

İbrahim Halil Albayrak 0000-0002-6448-2243

Mehmet Kenan Erol 0000-0003-1493-8828

Halil Çiftçi 0000-0002-4771-0232

Publication Date April 28, 2021
Submission Date March 3, 2021
Acceptance Date March 29, 2021
Published in Issue Year 2021 Volume: 18 Issue: 1

Cite

Vancouver Yağmur İ, Demir M, Katı B, Albayrak İH, Erol MK, Çiftçi H. Pediatrik Ürolitiyazis Tedavisinde Beden Dışı Şok Dalga Litotripsi (ESWL) Sonuçlarımız: Tek Merkez Deneyimi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2021;18(1):18-23.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty