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상부요관석에 대한 체외충격파쇄석술과 경성요관경하배석술의 치료결과 비교

Comparison of Shock Wave Lithotripsy (SWL) and Rigid Ureteroscopic Stone Removal (URS) for Treatment of Upper Ureteral Stones

Investigative and Clinical Urology v.45 no.5 , 2004년, pp.444 - 448  
김성수, 성봉모, 안승현
초록

Purpose: The aim of this study is to compare the shock wave lithotripsy (SWL) with the rigid ureteroscopic stone removal(URS) in order to establish the efficacy in treating upper ureteral stones according to the stone size. Materials and Methods: We reviewed 328 patients who have been treated for upper ureteral stones between January 1999 and December 2002. 227 patients were treated with SWL, and 101 patients were treated with URS. We analyzed the success rates of the stone removal, reasons for failure, and complication rates of each procedure. Results: The overall success rate of the URS was 93.1%. In terms of stone size, the success rates were 94.5%(<10mm) and 91.3%(>10mm), respectively. With the SWL treatments, the overall success rates after the first, second, and third sessions were 59%, 78%, and 92.5%, respectively. According to the stone size, the success rates were 96.5%(<10mm) and 85.7%(>10mm) after third sessions, respectively. The success rate was significantly affected by the size of the stone in the SWL group, but this was not the case with the URS group. The associated complication rates of URS and SWL were 11% and 7%, respectively. Conclusions: In this study, URS was relatively more efficacious than SWL when the stone was larger than 10 mm. The proper selection of patients for in situ SWL or URS would improve the results of the initial treatment. (Korean J Urol 2004;45:444-448)

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