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Register a new userPercutaneous Lithotripsy
تفتيت الحصيات الكلوية عبر الجلد
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Damascus University ورقة بحثية
Publication date
2011
fields
Medicine
and research's language is
العربية
Authors
عبدو خير شمس الدين( باحث )
Created by
Shamra Editor
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أمام إخفاق تفتيت الحصيات الكلوية من خارج الجسد في تدبير الحصيات الكلوية التي يزيد قطرها على 2 سم، فإن التفتيت عبر الجلد طريقة أثبتت فعاليتها في تدبير مثل هذه الحالات. و هذه الدراسة هي الأولى من نوعها في سورية على حالات طبقت عليها هذه الطريقة. مراجعة نتائج تفتيت الحصيات الكلوية عبر الجلد PCNL و تقييمها و خاصة فيما يتعلق باستطبابات الطريقة و مراحل العمل و الاختلاطات الممكن حدوثها، مع بحث سبل تطويرها في سورية.
Extra-corporeal shock wave lithotripsy (ESWL) has failed to manage renal stones > 2cm in diameter. Percutaneous nephrolothotomy lithotripsy (PCNL) has proved to be a very effective alternative. This study is the first study in Syria about PCNL, reflecting our own experience. To review and to evaluate the results of percutaneous lithotripsy (PCNL) for kidney stones, especially in regard of indications, steps of the procedures and possible complications.
Artificial intelligence review:
Research summary
تهدف الدراسة إلى تقييم نتائج تفتيت الحصيات الكلوية عبر الجلد (PCNL) كبديل فعال لتفتيت الحصيات من خارج الجسد (ESWL) الذي يفشل في إدارة الحصيات التي يزيد قطرها عن 2 سم. أجريت الدراسة بين عامي 2002 و2009 على 105 مريضًا في سوريا، بمتوسط عمر 37 عامًا. تم استخدام الأمواج فوق الصوتية لتفتيت الحصيات في 95 حالة (90.4%) والليزر في 10 حالات (9.5%). كانت النتائج إيجابية حيث تم إزالة الحصيات بالكامل في 73.3% من الحالات، بينما احتاج الباقون إلى متابعة العلاج بالأمواج الصادمة. كانت معظم الاختلاطات طفيفة وتم التعامل مع حالتين خطيرتين بنجاح. خلصت الدراسة إلى أن PCNL يعد طريقة فعالة وآمنة لتفتيت الحصيات الكبيرة وحصيات الكؤيس السفلي، ولكنها تتطلب خبرة واسعة وتوافر المعدات اللازمة لإدارة الاختلاطات المحتملة.
Critical review
دراسة نقدية: تعتبر هذه الدراسة إضافة قيمة للأدبيات الطبية في سوريا، حيث تقدم بيانات محلية حول فعالية وسلامة تقنية PCNL. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها. أولاً، كان من الأفضل تضمين مجموعة مقارنة من المرضى الذين خضعوا لتقنيات أخرى لتفتيت الحصيات لتقديم رؤية أكثر شمولية. ثانيًا، لم يتم توضيح تفاصيل المتابعة الطويلة الأمد للمرضى، مما يجعل من الصعب تقييم النتائج على المدى البعيد. أخيرًا، كان من الممكن تحسين الدراسة بإضافة تحليل اقتصادي لتكلفة PCNL مقارنة بالطرق الأخرى، مما يمكن أن يساعد في اتخاذ قرارات صحية مبنية على الأدلة.
Questions related to the research
-
ما هو الهدف الرئيسي من الدراسة؟
الهدف الرئيسي هو تقييم نتائج تفتيت الحصيات الكلوية عبر الجلد (PCNL) كبديل فعال لتفتيت الحصيات من خارج الجسد (ESWL) في سوريا.
-
ما هي نسبة نجاح تفتيت الحصيات بالكامل باستخدام PCNL؟
كانت نسبة نجاح تفتيت الحصيات بالكامل 73.3%.
-
ما هي الأدوات المستخدمة في تفتيت الحصيات في الدراسة؟
تم استخدام الأمواج فوق الصوتية في 90.4% من الحالات والليزر في 9.5% من الحالات.
-
ما هي أهم الاختلاطات التي واجهتها الدراسة وكيف تم التعامل معها؟
كانت معظم الاختلاطات طفيفة، وتم التعامل مع حالتين خطيرتين بنجاح.
References used
Alken P, Hutshenreiter G, Guenther R. Percutaneous kidney stone removal. Eur Urol 1982;8:304-11
Chaussy C, Schuller J, Schmiedt E, Brandl H, Jocham D, Liedl B. extracorporeal shock wave lithotripsy (ESWL) for treatment of urolithiasis. Urology 1984;23:59-66
Tiselius HG, Ackermann D, Alken P, et al. Guidelines on Urolithiasis. In: Guidelines of the EAU. European Association of Urology; 2001
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The main objective of the study is to select the best technique for lithotripsy of distal
ureteral stones .This study included 082 patients of distal ureteral stone at Al-Assad
University Hospital and Tishreen University Hospital in Latakia between
2016 and 2017.
64 patients who underwent ureteroscopic holmium laser lithotripsy and 216 patient who
underwent ESWL.The ages ranged from 19-72Years, The median age was approximately
37 year.
the success rate of distal ureteral lithotripsy using uretroscope-laser was 97% (100%
with stones> 1 cm, and 95% with stones< 1 cm) while it was 72% with the extracorporeal
lithotripsy(84% with stones > 1 cm, and 36% with stones < 1 cm).
The best results in treating the distal uretral stones were achieved by the use of
ureteroscope and laser lithotripsy, regardless of the stone size. While the extracorporeal
lithotripsy the best results was only with stones< 1 cm.
The aim of this study is to investigate the potential role of previous
Chlamydia Pneumoniae Infection on restenosis rate after Percutaneous
Transluminal Coronary balloon angioplasty.
Our data didn’t confirm the relationship between prior Chlamydia
Pneumoniae Infection and restenosis after PTCA. The results didn’t
support the use of antibiotics before or after PTCA to reduce the restenosis
after PTCA.
The possibility of using some agents used in traditional medicin .
Neoziland rabbits was used as experimental animals ; Fossil encrinites was used as a
treatment drug ; the disease was induced by injecting 120 mg of sodium glyoxylate intraperitonea
lly .
kidney calculi disease is a common health problem. At least 5% of women and 12% of men during their
lives suffer from kidney stones. Lots of herbal drugs and medicinal preparations are used in our country
in the treatment of kidney stones.
Purpose: We evaluated the safety of ESWL (Extracorporeal Shockwave Lithotripsy).
Materials and Methods: A total of 300 patients with stones located in the kidney or
the upper ureter were randomly divided into 3 groups, group A—100 who received ESWL
and they do not use anticoagulation drugs and thy do not have problems with kidneys, liver
or pancreas B—100 who received ESWL and they use anticoagulation drugs C—100 who
received ESWL and they have one kidney. Radiologic and laboratory follow up were
performed in the first week by:US –UREA-CR-ALT-AST-AMILAS. Statistical analysis
was performed using the chi square test and Anova test.
Results: The hematomas rate was 10.5%.Rates elevation of urea and cr was
(27%, 5%). Rate elevation of alt–ast was 12%, and for amylase was 6%, without clear
pathology.
Conclusions: ESWL is an easy, noninvasive, safe and active management of the
urinary stones, and we should be care full with some factors, which can increase its
complications and decrease its activity.
The fixation of the humeral,s supracondylare fractures in children by percutaneous pinning is considered a new and good principle in without the disadvantages that appear by treating it by open reduction and internal fixation . A prespective and pers
pective study was done for 48 kids whose old was between 2 – 14 year, those kids were admitted and treated surgically by these two methods ( pinning and ORIF ) In AL-ASSAD hospital in LATTAKIA in TISHREEN-UNIVERSITY in 2014 The ages of patients were between 2 – 14 , female ratio was ( 62.5% ) and male ( 37.5% ) the common reasons for these fractures were sportive and home accidents and the dominant upper limb was left . Fractures were isolate in 90% of cases and we noted 4 cases with accompanied and nondisplaced fractures in forearm and wrist that were treated conservatively . Pins and cast were removed in the four weeks . The more common complications were the secondary displacement , movement limitation and cubitus varus. The percutaneous pinning stills an easy way in understanding and application and gives good results for long period functionally and cosmetically , and this way has no important complications which can be avoided .
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