水電式體外震波器與電磁式體外震波器之效用與結果之比較 - 馬偕紀念醫院之經驗
Single center, single operator comparative study of the efficacy and outcomes of electrohydraulic and electromagnetic extracorporeal shock wave lithotriptors
Chih-Chiao Lee, MD, Ding-Po Lin, MD
To compare the efficacy and outcomes of two types of shock wave machines, the electrohydraulic lithotriptor (E3000) and electromagnetic lithotriptor (EM1000), as treatment of upper urinary tract stones.
The efficacy and outcomes of shock wave lithotripsy (SWL) using Medispec's E3000 electrohydraulic shock wave lithotriptor (179 cases) and Medispec's EM1000 electromagnetic shock wave lithotriptor (93 cases) in 272 patients with upper urinary tract stones between January 2011 and June 2013 were reviewed. The same operators performed all of the SWL treatments under the supervision of urologists in a single center. The demographic features, treatment parameters (i.e., stone site and size), and complications for both lithotriptors were analyzed. The patients were evaluated within 4 weeks after lithotripsy by plane abdominal X-ray. Treatment outcomes, including disintegration rate, stone-free rate, and retreatment rate, for both groups were also compared.
Pre-SWL, the patient characteristics, treatment parameters, and stone-related parameter were similar for both groups. There were higher stone-free and disintegration rates in the electrohydraulic group for most stones, but the retreatment rate was higher in the electromagnetic group. There was no significant difference for stones at the middle and lower ureter and stones in the ureter bigger than 1 cm. The complication rates for pain, skin, or subcapsular hematoma were not significantly different between groups.
The electrohydraulic lithotriptor (Medispec E3000) group has significantly higher disintegration and stone-free rates, but has similar complication rates compared to the electromagnetic lithotriptor (Medispec EM1000) group. There is no significant difference between the two groups for middle or lower ureteral stones and ureteral stones bigger than 1 cm. The electromagnetic lithotripter has the advantage of being useful for SWL even without anesthesia.