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Revista mexicana de urología
versión On-line ISSN 2007-4085versión impresa ISSN 0185-4542
Resumen
MEDRANO-URTECHO, Harvey Mauricio et al. Efficacy of kidney stone management through extracorporeal shock wave lithotripsy at a tertiary care center in Mexico City. Rev. mex. urol. [online]. 2019, vol.79, n.6, e04. Epub 24-Nov-2020. ISSN 2007-4085.
Background:
The incidence of urinary lithiasis in children is low (~3%). Extracorporeal shockwave lithotripsy is a first-line therapeutic alternative for kidney stones smaller than 20 mm. However, it has the disadvantage of a variable success rate (after the first session it varies from 60 to 90%) that is directly associated with stone size, density, and composition. The predictive factors for success of the procedure are stone load, lower infundibular length, and the infundibulopelvic angle (> 45o).
Objective:
To determine the overall efficiency of extracorporeal shock wave lithotripsy as treatment for kidney stones in the pediatric population at the Hospital General de México.
Material and methods:
A cross-sectional, analytic, retrospective study included 45 case records of pediatric patients that underwent extracorporeal shock wave lithotripsy as kidney stone management. The inclusion criteria were patient age from 1 to 18 years, stone diameter 20 mm, and stone located in the kidney; the exclusion criteria were patients > 18 years of age, stone diameter > 20 mm, stone located outside the kidney, obstruction, pregnancy, or blood dyscrasia; and the elimination criteria were patients with no radiologic follow-up (1 month).
Results:
Kidney stones were resolved in 28 patients, resulting in a success rate of 62.2% (95% CI: 47.5-77.0). The factors associated with therapeutic failure were stone size (p=0.03) and stone location in the kidney unit (p= 0.03).
Conclusions:
Our study results were similar to those reported in the literature for the management of kidney stones in the pediatric population, with respect to safety, efficacy, and stone-free status.
Palabras llave : ESWL; Pediatrics; Urolithiasis.