The effectiveness of extracorporeal shock wave lithotripsy for lower calyx stones in children

Abstract

Introduction. According to current clinical guidelines, the use of extracorporeal shock wave lithotripsy (ESWL) for lower calyx stones is indicated when their size is less than 1 cm. This is due to the low efficiency and high frequency of repeated procedures for larger stones.Purpose of the study. To examine the results of ESWL usage in the treatment of children with lower calyx stones of various sizes.Materials and methods. ESWL was performed on 33 children with lower calyx stones during 2013 - 2018 yrs. Patients were divided into 2 groups: Group I - 24 (72.7%) patients with primary stones, Group II - 9 (27.3%) patients after ESWL of kidney pelvis stones that migrated to the lower calyx. Both groups are divided into subgroups: a - children with stones less than 1 cm and b - with stones more than 1 cm. ESWL was performed under general anesthesia and ultrasound guidance. In all patients after ESWL we used the inversion technique. The result was considered positive in case of the complete elimination of stones was achieved.Results. After the first ESWL session, stone-free status was achieved in 21/33 (63.6%) patients of all groups, after the second ESWL session in 26/33 (78.8%), after 3 sessions - 30/33 (90.9%). In subgroups Ia and IIa, there were 14/22 (63.6%) children after the first ESWL with complete elimination of calculi, and after subsequent sessions, the success rate was 90.9% (20/22 calculi). After the first ESWL session in subgroups Ib and IIb, complete elimination of stones was achieved in 7/11 (63.6%) children, after repeated sessions in 10/11 (90.9%) children.Conclusions. ESWL demonstrates a high efficiency in the treatment of lower calyx stones less and more than 1 cm, both after the first and third sessions, and in the treatment of primary and residual (migrated) stones.