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Interventional stress in renal stone treatment.
MedLine Citation:
PMID:  21668328     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Abstract Purpose: To compare current minimally invasive strategies in renal stone treatment-shockwave lithotripsy (SWL), retrograde intrarenal surgery (RIRS), and minimally invasive percutaneous nephrolitholapaxy-with regard to interventional stress, measured by changes in interleukin (IL)-6 and C-reactive protein (CRP) serum levels during treatment. Patients and Methods: 143 patients underwent stone therapy for renal pelvic stone (SWL, n=40, mean age±standard error of the mean [SEM]: 48.3±3.1 years; RIRS, n=74, 54.5±1.8; and minimally invasive percutaneous nephrolitholapaxy (MIP), n=29, 54.6±2.7) between 2006 and 2007. Blood samples were prospectively collected 24 hours before and 24 hours after the procedure. Interventional stress was analyzed by changes of the acute phase proteins IL-6 and CRP. Results: Mean IL-6 (ng/L) difference (±SEM; 95% confidence interval [CI]) before and after therapy was +8.7 (±10.5; -13.9-31.2), +7.3 (±3.2; 1.5-13.1), and +20.5 (±8.1; 4.0-36.0) in the SWL, RIRS, and MIP groups, respectively (P=0.20). Differences in mean CRP (mg/dL) levels (±SEM; 95% CI) ranged between +0.9 (±1.6; -2.3-4.1) in SWL, +1.6 (±0.5; 0.6-2.5) in RIRS, and +1.8 (±,0.3, 1.2-2.5) in MIP patients (P=0.79). Mean stone sizes (mean/median mm(2)±SEM) differed significantly between SWL (27/20±3), RIRS (70/16±36), and MIP groups (346/160±104, P<0.0005). Conclusion: Contrary to common opinion that SWL is the least invasive therapy, the reported stress parameters did not show significant differences between SWL, RIRS, and MIP, although significantly bigger stones were treated with MIP.
Authors:
Stephan Kruck; Markus Sonnleithner; Joerg Hennenlotter; Ute Walcher; Arnulf Stenzl; Thomas R W Herrmann; Udo Nagele
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  25     ISSN:  1557-900X     ISO Abbreviation:  J. Endourol.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1069-73     Citation Subset:  IM    
Affiliation:
1 Department of Urology, University of Tuebingen , Tuebingen, Germany .
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