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V M Аrtyshchuk, D Z Vorobets, R Z Sheremeta

    Klinichna Khirurhiia
    |November 28, 2018
    PubMed
    Summary
    This summary is machine-generated.

    Extracorporeal shock-wave lithotripsy is best for larger infundibulopelvic angles, while transcutaneous nephrolithotripsy is effective for lower renal calyx calculi regardless of anatomical variations.

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    Area of Science:

    • Urology
    • Nephrology
    • Medical Technology

    Background:

    • Lower renal calyx (LRC) calculi pose treatment challenges.
    • Anatomical variations, such as infundibulopelvic angle (IPA), may influence treatment efficacy.
    • Understanding these factors is crucial for optimizing stone removal.

    Purpose of the Study:

    • To analyze the outcomes of treating lower renal calyx calculi in 276 patients.
    • To determine the influence of anatomical parameters on the effectiveness of different lithotripsy methods.
    • To provide evidence-based recommendations for selecting the optimal treatment modality.

    Main Methods:

    • Retrospective analysis of 276 patients with lower renal calyx calculi.
    • Classification of patients based on infundibulopelvic angle (IPA): blunt (n=118) and acute (n=158).

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  • Determination of 8 anatomical parameters of the LRC and assessment of treatment outcomes for extracorporeal shock-wave lithotripsy (ESWL) and transcutaneous nephrolithotripsy (TCNL).

    • Main Results:

    • Extracorporeal shock-wave lithotripsy (ESWL) demonstrated higher stone elimination rates with larger infundibulopelvic angles (IPA), smaller infundibulo-lumbar angles, and shorter LRC neck lengths.
    • Transcutaneous nephrolithotripsy (TCNL) proved effective irrespective of calculi dimensions, LRC neck length, IPA, or infundibulo-lumbar angle.
    • Patient stratification based on anatomical parameters can guide treatment selection.

    Conclusions:

    • The choice between ESWL and TCNL for lower renal calyx calculi should consider specific anatomical parameters.
    • ESWL is recommended for cases with wider infundibulopelvic angles and specific LRC neck characteristics.
    • TCNL offers a versatile and effective treatment option for lower renal calyx calculi across various anatomical presentations.