Zhang D. et al., 2022: The Clinical Efficacy and Safety of Extracorporeal Shock Wave Lithotripsy in the Treatment of Patients with Urinary Calculi.
Zhang D, Liang Z, Wang D, Lv J, Ding D, Yu D.
Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230032, China.
Department of Urology, Sinopharm Dongfeng General Hospital, China.
Objective: To evaluate the clinical efficacy of extracorporeal shock wave lithotripsy (ESWL) for urinary calculi and precautions of postoperative complications.
Methods: 90 patients with urinary calculi at our hospital were randomly recruited between July 2019 and July 2020 and were allocated (1 : 1) to receive either ESWL (observation group) or conventional surgery (control group). Clinical efficacy was the primary endpoint, whereas adverse events were the secondary endpoint.
Results: The operation time, early activity time, and hospitalization time of the observation group were significantly lower than those of the control group (P < 0.05). ESWL resulted in less postoperative pain in patients versus conventional surgery (P < 0.05). ESWL was associated with a significantly higher total clinical efficacy (97.78%) versus conventional surgery (82.22%) (P < 0.05). The eligible patients given ESWL had a lower incidence of complications (11.12%) versus those given conventional surgery (31.12%) (P < 0.05).
Conclusion: Hematuria prevention requires precise localization of stones as well as adjustment of pulse energy and the number of impacts due to stone changes. Precautions against renal colic necessitate complete comminution of stones intraoperatively, more postoperative water intake, moderate exercise, or injection of antispasmodic drugs and cathartics for pain relief. Nausea and vomiting precautions require preoperative recording of previous medical history and corresponding treatment, intraoperative real-time adjustment of voltage pulse frequency, and duration depending on the magnitude of intraoperative reaction. Urinary tract infection prevention requires preoperative prevention and proper postoperative anti-infection and anti-inflammatory treatment, along with enough water intake and bed rest. Other precautions include thorough comminution of the calculi, proper anti-infection and anti-inflammatory treatment, no early exercise or excessive activity after surgery, and proper postoperative care. ESWL is effective in treating patients with urinary calculi with a simple, safe, and quick operation and a low incidence of adverse events, as it effectively reduces the incidence of complications, accelerates the recovery of patients and improves their quality of life.
Markers. 2022 Oct 13;2022:3468692. doi: 10.1155/2022/3468692. eCollection 2022. PMID: 36277985 Clinical Trial. FREE ARTICLE
Read it! It’s free and fun.
This Free PMC article is not worth reading because it is about a small prospective randomized trial comparing ESWL versus “conventional surgery“. According to the authors conventional surgery is: “The specific operations are as follows: prepare the impact rod and ureteroscope, insert the impact rod into the ureteroscope, and connect the lithotripter when the stone is pressed against the ureteral wall to crush the stone. After that, the ureteral stone forceps were used to remove the slightly larger calculi after crushing, and the smaller calculi flowed out spontaneously through the ureteral drainage tube.” And so on!
The article is worth reading because it contradicts many facts you know about stone treatment and nearly everything you have learned so far about comparisons between ESWL and endourological stone removal. During and when having finished the reading my main thought was: This can't be true!
The paper was published in a journal of the Hindawi publisher bought by Wiley publishers in January 2021. On the Hindawi home page, it says about this journal: “Disease Markers is a peer-reviewed, open access journal that publishes original research articles and review articles related to the identification of disease markers, the elucidation of their role and mechanism, as well as their application in the prognosis, diagnosis and treatment of diseases.” As to the peer review process it says:
“All submitted articles are subject to assessment and peer review to ensure editorial appropriateness and technical correctness. Research published in the journal must be:
• Scientifically valid – adhering to accepted community standards of research.
• Technically accurate in its methods and results.
• Representative of a specific advance, or replication, or null/negative result, which is worthy of publication” …
Article processing charge is $2550.
As I continued to read up on publication policies in general, I came across some new terms that were previously unknown to me in the publication circus: "paper mills" and "coordinated peer review rings". (https://retractionwatch.com/2022/09/28/exclusive-hindawi-and-wiley-to-retract-over-500-papers-linked-to-peer-review-rings/)
However, I have found that it is easy to get lost in conspiracy theories and I have stopped following the trail of bad science. Instead, I looked where the clinic is located in China: The university hospital were the study comes from is in Hefei, the capital of Anhui Province. According to Wikipedia (https://en.wikipedia.org/wiki/Hefei), Hefei “is the political, economic, and cultural center of Anhui. Its population was 9,369,881 as of the 2020 census.”
Even a small murky brook needs a source and a streambed, a scientist and a publisher.