COMPARISON OF PNEUMATIC LITHOTRIPTER AND HOLMIUM YAG LASER IN TRANSURETERAL LITHOTRIPSY (TUL)

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  • Kitano Hiroyuki
    The Department of Urology, Nakatsu Daiichi Hospital, Nakatsu, Japan
  • Shinmei Syunsuke
    The Department of Urology, Hiroshima University School of Medicine, Hiroshima, Japan
  • Goriki Akihiro
    The Department of Urology, Hiroshima University School of Medicine, Hiroshima, Japan
  • Iwamoto Hideo
    The Department of Urology, Hiroshima University School of Medicine, Hiroshima, Japan
  • Hayashi Tetsutaro
    The Department of Urology, Hiroshima University School of Medicine, Hiroshima, Japan
  • Mutaguchi Kazuaki
    The Department of Urology, Nakatsu Daiichi Hospital, Nakatsu, Japan

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Other Title
  • 経尿道的尿管結石砕石術における圧縮空気破砕システムとHolmium YAG laserの治療成績における比較検討
  • ケイ ニョウドウテキ ニョウカン ケッセキ サイセキジュツ ニ オケル アッシュク クウキ ハサイ システム ト Holmium YAG laser ノ チリョウ セイセキ ニ オケル ヒカク ケントウ

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Abstract

(Objective) We retrospectively compared the clinical outcomes of Lithoclast® assisted lithotripsy (L group) with those of Holmium YAG laser assisted lithotripsy (H group). (Patients and methods) We analyzed records for operation time, duration of ureteral stenting, complication and stone-free rates in the L group (388 patients) and the H group (368 patients) for the primary procedure. (Results) The stone locations (L group/H group) were U1 in 141/181, U2 in 69/57, and U3 in 178/130. Respective median stone sizes (L group/H group) were: U1,: 10.0/10.0 mm; U2,: 7.0/10.0 mm;, and U3,: 6.0/7.0 mm. Secondary procedures were performed in 79 L group patients and 35 H group patients. The median operation times (L group/H group) were 29.5/25.0 minutes. The median durations of ureteral stenting (L group/H group) were 4.0/4.0 days. The stone-free rates (L group/H group) according to the locations of the stones were 69.3/82.0% in U1, 85.5/87.0% in U2, and 92.0/98.4% in U3. Complications (L group/H group) were ureter perforation in 8/5 cases, pyelonephritis in 7/2 cases, ureteral stricture in 2/6 cases, and stone push up in 27/13 cases. (Conclusion) The operation time for holmium YAG laser assisted lithotripsy was significantly shorter than that of the Litoclast® assisted procedure, and the stone-free rate with holmium YAG laser assisted lithotripsy was better than that with Lithoclast® assisted lithotripsy for U1 and U3 stones.

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