體外震波碎石術中應用能減少空氣含量之新型固態藕合墊片的先期研究
陳偉權 張志宏 陳建旭 劉文欽1 楊儀華1
天主教聖功醫療財團法人 聖功醫院1 泌尿外科
A Preliminary Study of a New Solid Coupling for Reducing Trapped Air Pockets and Application in Extracorporeal Shock Wave Lithotripsy
Wei-Chuan Chen, Chih-Hung Chang, Jian Shiu Chen, Wen-Chin Liou,
Yi-Hua Yang
Division of Urology Department of Surgery St. Joseph Hospital, Kaohsiung
Purpose: This study was to compare the results of extracorporeal shock wave lithotripsy (ESWL) between patients using a solid proprietary isolation-coupling pad ("icPad") (Group A) and those with semi-liquid gel (group B) as a coupling interface during ESWL to treat renal and ureteral stones.
Materials and Methods: There were 188 patients who underwent ESWL between September 2017 and February 2018 in the study, of which 96 patients were treated in the Group A and 92 in the Group B. The lithotripter used in the study was an electromagnetic Dornier Compact Sigma. The stone disintegration rates (SDRs) were defined decreased stone burden or complete stone passage using KUB film with or without ultrasonography 1-3 months after ESWL. Complications during the intraoperative or post-operative periods were recorded.
Results：There was no significant difference in patient and stone characteristics between the two groups. The SDRs were 77 % for renal stones and 96 % for ureteral stones in patients from Group A. The corresponding SFRs for patients in Group B were 77% and 90 %. Significant differences of existed in treatment results of ureteral stones between the two groups (P< 0.05). No major complications were noted.
Conclusions: Our results suggests that IcPad as an interface in ESWL can markedly reduce air pockets in coupling and lead to more SDRs due to better shock wave conduction. Furthermore, potential cross contamination by blood or fluid extravasated from skin tissue between ESWL treatments can be avoided. However, further investigation should be performed to determine whether these results can also indicate that the numbers of shockwave hits and energy level may be reduced due to icPad’s superior efficacy.