Document Detail


Treatment of ureteric calculi--use of Holmium: YAG laser lithotripsy versus pneumatic lithoclast.
MedLine Citation:
PMID:  18072637     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the efficacy of Holmium: YAG laser and pneumatic lithoclast in treating ureteric calculi. METHODS: The study included total of 100 patients divided into two equal groups of laser lithotripsy (LL) and pneumatic lithoclast (PL). Study was conducted between September 2006 and February 2007. Inclusion criteria were patients with a ureteric stone of size 1-2 cm and negative urine culture. An x-ray KUB was mandatory. IVU and CT pyelogram were also done when required. Procedures were done under general anaesthesia after a single dose of pre-operative antibiotic. A 7.5 Fr semi rigid ureteroscope was used for ureteroscopy in all cases. Holmium: YAG laser with 365 microm wide probe was employed in laser group and frequency was set between 5 and 10 Hz at a power of 10 to 15 W. Swiss lithoclast with single or multiple fire technique was used accordingly in PL group. Postoperatively patients underwent radiography and helical CT as required at 4th week of follow up to asses stone clearance. RESULTS: The mean patient age in LL and PL group was 38 +/- 10 and 40 +/- 10 years respectively. The male to female ratio and stone size were similar between the groups. Stone migration up in pelvicalyceal system occurred in two patients of LL group while in eight patients of PL group. JJ Stent was placed in 5(10%) patients in laser group where as 13 (26%) patients required it in pneumatic lithoclast group. Stone free rate at 4 weeks was 92% in laser group as compared to 82% in pneumatic lithoclast group. Hospital stay was more than 24 hours in 2 patients of laser group as compared to 5 patients of pneumatic lithoclast group. Complication rate was 4% in LL group whereas it was 14% in PL group. CONCLUSION: Holmium: YAG laser lithotripsy is a superior technology compared to pneumatic lithoclast in terms of rate of stone clearance and complications, especially in upper ureteric stones.
Authors:
Salman Ahmed Tipu; Hammad Afzal Malik; Nazim Mohhayuddin; Gauhar Sultan; Manzoor Hussain; Altaf Hashmi; Syed Ali Anwar Naqvi; Syed Adibul Hasan Rizvi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  JPMA. The Journal of the Pakistan Medical Association     Volume:  57     ISSN:  0030-9982     ISO Abbreviation:  J Pak Med Assoc     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-12-12     Completed Date:  2008-01-17     Revised Date:  2008-02-12    
Medline Journal Info:
Nlm Unique ID:  7501162     Medline TA:  J Pak Med Assoc     Country:  Pakistan    
Other Details:
Languages:  eng     Pagination:  440-3     Citation Subset:  IM    
Affiliation:
Sindh Institute of Urology and Transplantation, Karachi.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cross-Sectional Studies
Female
Holmium / therapeutic use*
Humans
Lithotripsy / instrumentation,  methods
Lithotripsy, Laser / methods*
Male
Pakistan
Ureteral Calculi / therapy*
Ureteroscopy
Chemical
Reg. No./Substance:
7440-60-0/Holmium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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