Anesthesia for extracorporeal shockwave lithotripsy: Teikyo University Hospital experience using the third generation...

Area of Science:

• Urology
• Nephrology
• Medical Devices

Background:

• Urolithiasis, the formation of stones in the urinary tract, affects a significant portion of the population.
• Extracorporeal shock wave lithotripsy (ESWL) is a primary treatment modality for kidney and ureteral stones.
• Advancements in lithotripter technology aim to improve stone-free rates and minimize complications.

Purpose of the Study:

• To evaluate the efficacy and safety of the Dornier Compact Delta lithotripter for treating renal and ureteral stones.
• To assess the impact of anesthesia on lithotripsy outcomes.
• To compare the performance of the Dornier Compact Delta with other available lithotripters.

Main Methods:

• A total of 502 patients with renal (185) and ureteral (317) stones were treated using the Dornier Compact Delta lithotripter.
• Treatments were performed under general or epidural anesthesia.
• Data collected included stone location, size, shockwave parameters, stone-free rates, and complications.

Main Results:

• The Dornier Compact Delta lithotripter achieved a stone-free rate of 71.5% for renal stones and 99% for ureteral stones.
• The majority of treated stones (61.8%) were smaller than 1 cm.
• A single complication of perinephric hematoma requiring transfusion was reported.

Conclusions:

• The Dornier Compact Delta lithotripter demonstrates high efficacy and feasibility for treating urolithiasis.
• Performing lithotripsy under anesthesia can enhance treatment effectiveness, even with third-generation machines.
• This technology offers a promising treatment option with a favorable success rate.