Title: A retrospective study to compare Extracorporeal shock wave lithotripsy in or upper urinary tract stones in paediatric and adults patients
Authors: Dr Ahsan Ahmad, Dr Khalid Mahmood, Dr Gaurav Kumar Mishra, Dr Gaurav Singh
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.70
Abstract
Objective: The main objective of the study was to compare and evaluate efficiency and safety of extracorporeal shock wave lithotripsy (ESWL) for upper urinary tract stones by using an electromagnetic lithotripter in children and adults.
Methods: Patients who had renal, solitary, and upper ureteric stones measuring <2 cm were retrospectively analysed over a period of 5 years where treatment method was used by ESWL done by Dornier Compact Delta (Dornier Medical Systems, Inc., Marietta, Ga, USA). 56 paediatric patients (age 5.7±3.8 years) was consider as Group A and 435 adults (age 44.3±14.2 years) was consider as Group B. Until adequate fragmentation was achieved, energy as well as number of SWs used was tailored and was not predetermined. Reassessment of initial stone was conducted at 48 hour and monthly thereafter. In each group the number of stone-free rate, auxiliary procedure rate, SWs, intensity of SWs, retreatment rate, effectiveness quotient and complication rate were assessed.
Results: It was observed that 85% was the stone-free rate with ESWL in paediatric patients and the same was 87% in adults with a p value of 0.69. Among the paediatric and adults the EQ was 78% and 77% respectively. Energy and number of SWs required per session was 948±334 and 11.64±0.72 kV in paediatric and 1348±431 and 12.81±0.29 in adults with a statistically significant differences (P< 0.001). It was found to be similar among both the groups as per as complication rates and re-treatment, auxiliary procedure is concern.
Conclusion: For patients having renal, solitary, and upper ureteric stones measuring <2 cm ESWL is as effective and safe in paediatric as well as in adults. To achieve equivalent results significantly fewer and lower energy SWs were required in paediatric patients as compare to adults.
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