Clinical experience with EDAP LT-01+ extracorporeal shock wave lithotripsy in 25 staghorn calculi

Seo, Kie Seok; Rim, Joung Sik

Abstract

From February 8. 1990 to November 30, 1991, 25 patients with staghorn calculi were underwent extracorporeal shock wave lithotripsy(ESWL) using the EDAP LT-01 lithotriptor. We reviewed patients with staghorn calculi to evaluate the effectiveness of ESWL as monotherapy for staghorn calculi and determine the selection criteria for the treatment calculi. The results were obtained as follows : l. Ten patients had complete staghorn calculi filling the complete renal collecting system with stone of l7,635 mm3 in mean volume and l3 patients had partial staghorn calculi filling the renal pelvis and partial caliceal groups with stone of 7,017 mm3 in mean volume. 2. Of 17 patients with stone of less than 8,200 mm3 in volume. 10(83.3%)remained free of stone after an average 11.8 sessions. Of 6 patients with stone of between 8,200 to 14,200 mm3 volume, 5(83.3%) remained free of stone after an average 18.3 sessions. Of 7 patients with stone of more than l4,200 mm3 in volume, 2(28.6%) remained free of stone after an average 17.4 sessions 3. When these patients were stratified by stone burden, of 10 patients with stone filling a non-dilated renal collecting system, all(100%) patients remained free of stone. Of 15 patients with filling a dilated renal collecting system. 7 (46.7%) patients remained free of stone. Of 8 cases with residual stones. 2 patients were underwent open surgery(nephrectomy, extended pyelolithotomy), 2 patients were impossible to follow up and 4 patients still are undergoing continuous additional ESWL sessions. 5. Double J stent for the pre-ESWL additional measures were placed in 19 patients(76%); Eight of the complete staghorn calculi and 11 of the partial staghorn calculi. Percutaneous nephrostomy tube was placed in 2 patients. No general or regional anesthesia was required. 6. The post-ESWL complications were ureteral obstruction(steinstrasse) in 7 patients(28%) and high fever(over 38.5 degrees C) in 11 patients( 44.0%). We conclude that partial staghorn calculi, staghorn calculi with stone of less than 14,200 mm3 in volume and staghorn calculi with stone burden filling non-dilated collecting system are eligible for ESWL.