상부 및 중부요관결석의 치료: Holmium: YAG Laser를 이용한 반강성 요관경하배석술과 체외충격파쇄석술의 비교
Treatment of Upper and Mid Ureter Stones: Comparison of Semirigid Ureteroscopic Lithotripsy with Holmium: YAG Laser and Shock Wave Lithotripsy
권용욱, 이상익, 정태융,
소속 상세정보
권용욱 ( Kwon Yong-Uk )
관동대학교 의과대학 비뇨기과학교실
이상익 ( Lee Sang-Ik )
관동대학교 의과대학 비뇨기과학교실
정태융 ( Jeong Tae-Yoong )
관동대학교 의과대학 비뇨기과학교실
KMID : 0358320070480020171
Abstract
Purpose: To compare the success rates, complications and cost effectiveness of extracorporeal shock wave lithotripsy(ESWL) and ureteroscopic lithotripsy(URS) using a Holmium: YAG laser to establish the more effective treatment for upper and mid ureter stones.
Materials & Methods: This retrospective study included 83 and 286 patients treated with URS and ESWL, respectively, for upper and mid ureter stones. URS was performed with a 7.5Fr semi-rigid ureterorenoscope and Holmium: YAG laser. ESWL was performed with Stonelith V.5 (PCK, Turkey). The stone sizes, success rates, postoperative complications and cost effectiveness were analyzed for each group.
Results: The overall success rates of the URS and ESWL were 97.6 and 82.5%, respectively. Success rates of URS were 98.4 and 95.2% when the stones were smaller and larger than 10mm, respectively. In the ESWL group, the success rates after the third session were 86.3 and 65.4% with stones smaller and larger than 10mm, respectively. The complication rates associated with URS and ESWL were 6 and 4.2%, respectively. The average cost of URS was lower than that of ESWL.
Conclusion: In our study, URS with Holmium: YAG laser was more efficacious than ESWL. Considering both the success rate and cost effectiveness, URS should remain the recommended first-line treatment for upper and mid ureter stones. (Korean J Urol 2007;48:171-175)
키워드
Ureter stone;Extracorporeal shockwave lithotripsy;Ureteroscopy;Holmium
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