腎鋳型結石の体外衝撃波砕石術単独療法

EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY MONOTHERAPY FOR RENAL STAGHORN CALCULI

　X線上の長径3cm以上の腎鋳型結石に対する体外衝撃波砕石術（ESWL）単独分割療法を検討した。ESWLは尿管ステント留置後に，Lithostar^Rを使用し，計画分割療法（衝撃波数制限：最大6000発／治療機会，治療機会制限：1治療機会／2〜4週間）とした。31症例33結石のうち，ESWL開始3ヵ月後で完全排石17（17／33＝51.5％），小残石（4 mm以下）のみ7（7／33＝21.2％）であった。残り9結行中8結行は，ESWL開始後5〜10カ月で小残石のみとなり，結局32結石（32／33＝97.0％）で完全排石あるいは小残石のみの著効が得られた。

Thirty-three renal staghorn calculi over 3cm in longer diameter on plain X-ray film were treated and followed for more than 3 months after initiation of Extracorporeal Shock Wave Lithotripsy (ESWL) monotherapy. For ESWL monotherapy, Lithostar (Siemens Co.) was used with internal ureteral stents. ESWL monotherapy was consisted of limitted shots (max. 6000 shots/session) and interval (more than 2-4 weeks between sessions). At 3rd month after the first ESWL session, 17 (17/33=51. 5%) were stone-free and 7 (7/33=21. 2) were with only small residua.