STORZ MEDICAL – Literature Databases
STORZ MEDICAL – Literature Databases
Literature Databases
Literature Databases

Li Y. et al., 2023: Effect of external physical vibration lithecbole in obese patients with lower pole stones

Li Y, Lv J.
Department of Urology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China.

Abstract

Objective: To investigate the efficacy and safety of external physical vibration lithecbole (EPVL) in obese patients with <15 mm lower pole stones following extracorporeal shock wave lithotripsy (ESWL).

Methods: Two hundred and ninety-nine obese patients with BMI greater than 30 kg/m2 and lower pole stones smaller than 15 mm were prospectively randomized into two groups. While ESWL was the only option in the control group, patients in the treatment group accepted EPVL after receiving ESWL. Imaging tests were used to compare the stone expulsion status on day 1 and the stone-free rates (SFR) on the first, second, and fourth weekends.

Results: All 299 obese patients were randomly divided into two groups, with 152 patients assigned to the treatment group and 147 assigned to the control group. EPVL was effective in facilitating the expulsion of stone fragments. The treatment group's stone expulsion rate on the first day following EPVL was significantly greater than the control group's (66.4% vs. 51.7%, p = 0.009). Stone clearance rates in the treatment and control groups were 63.2 and 55.1% at 1 week (p = 0.041), 84.9 and 70.7% at 2 weeks (p = 0.011), and 90.8 and 79.6% at 4 weeks (p = 0.017), respectively. The complications (hematuria, lumbago, and fever) between the groups did not show any significance (p > 0.05). Patients in the treatment group received an average of 5.2 sessions.

Conclusion: EPVL is an efficient and secure procedure that facilitates lower pole stone discharge in obese patients following ESWL treatment. To support the aforementioned conclusions, additional large-scale multi-center prospective studies are required.

Front Med (Lausanne). 2023 Aug 30;10:1101811. doi: 10.3389/fmed.2023.1101811. eCollection 2023. PMID: 37711736 FREE ARTICLE

1
 

Comments 1

Hans-Göran Tiselius on Friday, 08 March 2024 10:00

Stone removal with SWL is attractive because it eliminates stone material non-invasively (or in a least invasive way) without general or regional anesthesia. Almost 40 years of experience with SWL has taught me that satisfactory stone disintegration almost always can be obtained with a sufficient level of ambition, a strategy that sometimes might require repeated sessions. The most annoying feature of SWL, however, is the common occurrence of residual fragments, particularly in the lower caliceal system. In these patients the explanation is not insufficient disintegration (if SWL is carried out in an optimal way), but the result of poor elimination of fragments because of anatomical and gravitational factors.

In this regard obese patients constitute a group with special problems. The long SSD might weaken the shock wave power whereas reduced patient mobility contributes to low fragment elimination. In this study the authors used a vibration device (EPVL) to increase fragment elimination. Higher stone-free rates were recorded in patients treated with SWL+EPVL than in patients treated with only SWL. Although the difference between the groups was relatively small, the results nevertheless showed that a mechanical vibration device is of great value.

It is surprising how little attention vibration devices have raised in centers dealing with SWL. The most important interest and progress has been noted in China.

There certainly is a great potential to get even better results with improved devices for fragment elimination and thus maintain the non-invasive character of SWL and keep the treatment cost much lower than that of PCNL, URS and RIRS. The authors of this report treated stones in LC with diameters

Stone removal with SWL is attractive because it eliminates stone material non-invasively (or in a least invasive way) without general or regional anesthesia. Almost 40 years of experience with SWL has taught me that satisfactory stone disintegration almost always can be obtained with a sufficient level of ambition, a strategy that sometimes might require repeated sessions. The most annoying feature of SWL, however, is the common occurrence of residual fragments, particularly in the lower caliceal system. In these patients the explanation is not insufficient disintegration (if SWL is carried out in an optimal way), but the result of poor elimination of fragments because of anatomical and gravitational factors. In this regard obese patients constitute a group with special problems. The long SSD might weaken the shock wave power whereas reduced patient mobility contributes to low fragment elimination. In this study the authors used a vibration device (EPVL) to increase fragment elimination. Higher stone-free rates were recorded in patients treated with SWL+EPVL than in patients treated with only SWL. Although the difference between the groups was relatively small, the results nevertheless showed that a mechanical vibration device is of great value. It is surprising how little attention vibration devices have raised in centers dealing with SWL. The most important interest and progress has been noted in China. There certainly is a great potential to get even better results with improved devices for fragment elimination and thus maintain the non-invasive character of SWL and keep the treatment cost much lower than that of PCNL, URS and RIRS. The authors of this report treated stones in LC with diameters
Monday, 20 May 2024