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Extracorporeal shock-wave lithotripsy is best for larger infundibulopelvic angles, while transcutaneous nephrolithotripsy is effective for lower renal calyx calculi regardless of anatomical variations.
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).
- 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.
Abstract:
Results of treatment of 276 patients, suffering the lower renalis calyx (LRC) calculi, hav' ing size (1.14 ± 0.35) сm, were analyzed. Depending on acuteness of іnfundibulo— pelvic angle (ІPA) the examined persons were divided on groups with blunt (n=118) and acute (n=158) IPA; 8 аnatomic parameters of the LRC were in total determined. There was established, that еxtracorporal shock—wave lithotripsy, in accordance to the cal' culated index of a LRC calculis elimination, is expedient to apply in a bigger ІPA, lesser іnfundibulo—lumbar angle, lesser length of the LRC neck; transcutaneous nephrolithotripsy is effective not depending from a calculi dimensions, length of the LRC neck, value of ІPA and infundibulo—lumbar angle.