Comparative evaluation of clinical effectiveness of different minimally invasive methods of treatment ureterolitiaza
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Abstract
In recent years increase in incidence and prevalence of urinary stone disease (USD) was noticed in Armenia (increase in incidence 3.8 and in prevalence – 2.5 times). Extracorporeal shock wave lithotripsy (ESWL), contact uretherolithotripsy (including laser-assisted - CLLT ) and percutaneous nephrolithotripsy (PCNL) are “gold standard” treatment for USD with ureteral stones.
The objective: сomparative evaluation of clinical efficacy of ESWL, PCNL and CLLT in patients with large stones (>1cm) in proximal part of ureter.
Patients and methods. One hundred eighty patients with ureterolithiasis who underwent different surgical procedures for stone removal in “Erebouni” Medical Center. Patients were divided into 3 clinical groups: 1st – 60 patients who underwent ESWL, 2nd – 60 patients who underwent PCNL, 3rd – 60 patients who underwent CLLT.
Results. Clinical efficacy of ESWL (“Stone free”) was 93.3%, PCNL – 98.3% and CLLT – 98.3%. Odds ratio of becoming “Stone free” in the 1st group compared to the 2nd group was 0.237 with 95% CI from 0.026 to 2.188, that indicates higher chance of becoming “stone free” in the 2nd and 3rd clinical groups (after PCNL and CLLT) than in the 1st group (after ESWL).
Conclusions. Therefore, there is definite connection between risk factor (type of surgery) and outcome (“stone free”), that is: chance to become “stone free” is higher after PCNL and CLLT than after ESWL.
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