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首页> 外文期刊>The Journal of Urology >Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less.
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Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less.

机译：一项前瞻性随机试验比较了冲击波碎石术和输尿管镜检查下极小结石结石1厘米或更小。

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PURPOSE: The optimal management of lower pole renal calculi is controversial. We compared shock wave lithotripsy (SWL) and ureteroscopy (URS) for the treatment of patients with small lower pole stones in a prospective, randomized, multicenter trial. MATERIALS AND METHODS: A total of 78 patients with 1 cm or less isolated lower pole stones were randomized to SWL or URS. The primary outcome measure was stone-free rate on noncontrast computerized tomography at 3 months. Secondary outcome parameters were length of stay, complication rates, need for secondary procedures and patient derived quality of life measures. RESULTS: A total of 67 patients randomized to SWL (32) or URS (35) completed treatment. The 2 groups were comparable with respect to age, sex, body mass index, side treated and stone surface area. Operative time was significantly shorter for SWL than URS (66 vs 90 minutes). At 3 months of followup 26 and 32 patients who underwent SWL and URS had radiographic followup that demonstrated a stone-free rate of 35% and 50%, respectively (p not significant). Intraoperative complications occurred in 1 SWL case (unable to target stone) and in 7 URS cases (failed access in 5 and perforation in 2), while postoperative complications occurred in 7 SWL and 7 URS cases. Patient derived quality of life measures favored SWL. CONCLUSIONS: This study failed to demonstrate a statistically significant difference in stone-free rates between SWL and URS for the treatment of small lower pole renal calculi. However, SWL was associated with greater patient acceptance and shorter convalescence.
机译：目的：下极肾结石的最佳治疗尚存争议。在一项前瞻性，随机，多中心试验中，我们比较了冲击波碎石术（SWL）和输尿管镜检查（URS）对小下极结石患者的治疗效果。材料与方法：将78例孤立的下极结石小于或等于1厘米的患者随机分为SWL或URS。主要结局指标为3个月时无对比计算机断层扫描的无结石率。次要结果参数为住院时间，并发症发生率，是否需要次要程序以及患者的生活质量测量。结果：总共67例随机分配至SWL（32）或URS（35）的患者完成了治疗。两组在年龄，性别，体重指数，侧面处理和结石表面积方面具有可比性。 SWL的手术时间明显短于URS（66分钟比90分钟）。随访3个月时，接受SWL和URS的26例和32例患者的影像学随访结果显示无结石率分别为35％和50％（p不显着）。术中并发症发生在1例SWL病例（无法靶向结石）和7例URS病例（5例失败进入和2例穿孔），而术后并发症发生在7例SWL和7例URS。以患者为依据的生活质量衡量标准支持SWL。结论：这项研究未能证明SWL和URS治疗小下极肾结石的无结石率有统计学差异。但是，SWL与更大的患者接受度和更短的康复时间有关。

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