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Register a new usercomparison of lithotripsy results for lower third ureteric stones by Extacorporeal shock-wave lithotripsy(ESWL) versus ureteroscopyic-laser lithotripsy
مقارنة نتائج تفتيت حصيات الثلث السفلي للحالب بواسطة الأمواج الصادمة من خارج الجسم (ESWL) و تفتيتها بالليزر عبر المنظار الحالبي
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Tishreen University ورقة بحثية
Publication date
2018
fields
Medicine
and research's language is
العربية
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الهدف الأساسي من الدراسة هو اختيار الأفضل و المثلى في تفتيت حصيات أسفل الحالب، و مقارنتها مع الدراسات العالمية. شملت الدراسة 280 مريض لديهم حصيات أسفل الحالب راجعوا مشفى تشرين الجامعي و مشفى الأسد الجامعي بين عامي 2016-2017، حيث خضع 64 مريض للتفتيت بالليزر عبر المنظار الحالبي، و خضع 216 مريض للتفتيت بالأمواج الصادمة من خارج الجسم (ESWL)، تراوحت أعمار المرضى بين 19-72سنة و كان العمر الوسطي تقريباً 37 سنة، كانت نسبة نجاح تفتيت الحصيات في أسفل الحالب باستخدام المنظار الحالبي و الليزر 97%( 100% في الحصيات < 1 سم، 95% في الحصيات>1سم)،أما تفتيت الحصيات بالأمواج الصادمة من خارج الجسم (ESWL) فكانت بحدود 72%(84% في الحصيات < 1سم، 36% في الحصيات >1سم). إنَّ تفتيت الحصيات أسفل الحالب من خلال المنظار الحالبي بالليزر أعطت نتائج أفضل بمختلف أحجام الحصيات، أما تفتيها بالأمواج الصادمة من خارج الجسم فكنت النتائج جيدة فقط في الحصيات الأصغر من 1سم.
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.
References used
DAVISON AM, CAMERON JS, GRUNFELD J-P,KERR DN, RITZ E, WINEARLS CG, eds. Oxford textbook of clinical nephrology. 3rd edn. Oxford: Oxford University Press, 2010, 1201-1223
DEIRDRE M. COLL, MICHAE J. VARnelli2 and ROBERT . Smith Relationship of Spontaneous Passage of Ureteral Calculi to Stone Size and Location as Revealed by Unenhanced Helical CT
GLENN, M. PREMINGER, M.D. Guideline of urology. The Management ofUreteral Calculi: Diagnosis and Treatment.- 2011, 51-69
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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, ref
lecting 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.
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.
Background: Kid's body has major ability for remodeling and correcting all of
displacement that could happened on fractures.There is many ways for treatment of these
fracture,we can put them in tow guidelines:
Surgical treatment, conservative trea
tment.
Aim: Comparison between conservative treatment result and result of surgical
treatment via ESIN in treatment of midshaft forearm fractures in children, and chose the
best method that achieve healing in fast time and with less complications.
Methods: the study included 40 kids ,that have been chosen in random way from
children that came to the ER and clinics in Alassad and Tishreen university hospitals in
time between 2012 and 2017,with age of 9 to 14 years.
Results: The results were similar between conservative treatment and surgical
treatment via esin according to healing ,time at hospital ,and costs .time to return to daily
life is shorter in surgical treatment. complications were found in two methods but there
were no effect on the extremity or the child.
Our study included 40 patients with a single length of less than 1 cm Urethral Stricture, between the ages of (20-75) years, reviewed the Assad University Hospital (Urinary clinic and Emergency Room) in Latakia between 2011 - 2012.
Patients were dis
tributed in two groups (A)-(B).
The first group were treated using the technique of laser helium.
The second group treated using a cold knife (a traditional biopsy).
Patients were distributed in both groups without any considerations or statistical differences in the Pathogenicity mechanism, the stricture site, or any clinical diseases caused by them, but that all patients have a a single Urethral Stricture that does not exceed a length of 1 cm.
The effectiveness of treatment were then evaluate using Uroflowmetry, where all patients was conducted to measure the rate of flow of urine before treatment and after treatment at 3 months and then after 6 months.
Statistical study showed clear differences in the efficiency of treatment in favor of laser Urethrotomy(0,05> P).
As we compare our results with three global studies and pointed to the compatibility with sites.
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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