J.Jpn. Surg. Soc.. 87(9): 992-995, 1986

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Report on the annual meeting

NEW MODALITY OF UROLITHIASIS TREATMENT

Extracorporeal shock wave lithotripsy (ESWL) is a newly developed method which disintegrates renal stone without surgery. In addition to ESWL, percutaneous or transurethral techniques to treat urolithiasis have been widely accepted as alternative treatments to lithiasis surgery.
In 1985, we treated 90 patients by ESWL. The results show：
(1) ESWL had distinctive advantages over surgery because of no requirement of skin incision, repeatability, short hospital stay and small invasiveness. In fact serious complication was not encountered in this series.
(2) As the size of stone became larger, i) repeated shock waves were required. ii) the frequency of residual fragments increased. iii) the frequency of fever and pain attack increased.
In consideration of the results of ESWL monotherapy, 16 patients with staghorn calculi were treated by combination of percutaneous nephrolithotripsy (PNL), ESWL and chemolysis. Satisfactory result was obtained in 72% cases. The post-treatment evaluation showed no impairment of renal function. The combined method is better than nephrolithotomy or partial nephrectomy in the treatment of staghorn calculi because of small invasion, preservation of renal function and repeatability.
Our clinical experiences suggest that less invasive methods will be accepted overwhelmingly for lithiasis treatment.

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