Information de reference pour ce titreAccession Number: | 00125504-200505070-00029.
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Author: | DE DOMINICIS, MAURO; MATARAZZO, ENNIO; CAPOZZA, NICOLA; COLLURA, GIUSEPPE; CAIONE, PAOLO
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Institution: | Division of Paediatric Urology, Department of Nephrology and Urology, 'Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy
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Title: | |
Source: | BJU International. 95(7):1049-1052, May 2005.
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Abstract: | OBJECTIVE: To compare the efficacy and safety of ureteroscopy plus intracorporeal lithotripsy (ULT) with extracorporeal shock wave lithotripsy (ESWL) for treating distal ureteric calculi in childhood, as such stones are commonly treated by ESWL as the first option in adults but there is no agreement on the method of treating them in children.
PATIENTS AND METHODS: From July 2002 to July 2003, children presenting with ureteric stones were consecutively randomized for treatment using ULT or ESWL. The two groups were matched for age, sex and stone position in the distal ureter. A 7.5 F ureteroscope combined with a ballistic lithotripter or holmium-YAG laser was used for ULT. ESWL was administered using a second-generation lithotripter. The success rate, effectiveness quotient, complication rate and hospitalization were evaluated and compared using Student's t-test (chi-square) and Fisher's exact test as appropriate. In all, 31 patients (21 girls and 10 boys, mean age 7.2 years, range 2-17) were treated, by ULT in 17 (12 girls and five boys) and ESWL as a primary procedure in 14 (five boys and nine girls).
RESULTS: After one ULT, all the girls and four boys, and after ESWL, four girls and two boys, were rendered stone-free at the first treatment. The total stone-free rate was 16 of 17 for ULT and six of 14 for ESWL (P = 0.004). Eight patients had a second ESWL and three then became stone-free. The five patients in whom both ESWL treatments failed had a successful ULT. There was no significant difference between the groups in complication rate and hospitalization. General anaesthesia was required in all patients <12 years old treated by ULT or ESWL. The calculated efficiency quotient for treating distal ureteric calculi was significantly lower for ESWL than ULT (P < 0.05).
CONCLUSIONS: ULT should be recommended as the treatment of choice for distal ureteric calculi in children; using small ureteroscopes the target stone was treated safely and effectively.
Copyright (C) 2005 Blackwell Publishing Ltd.
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Author Keywords: | stones; children; distal ureter; ureterolithotripsy; ESWL.
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Language: | English.
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Document Type: | Paediatric Urology.
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Journal Subset: | Clinical Medicine.
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ISSN: | 1464-4096
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NLM Journal Code: | dcu, 100886721
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