Zusammenfassung
Die interventionelle Steintherapie beinhaltet im Wesentlichen 3 Therapiemodalitäten. Hierbei stellt die extrakorporale Stoßwellenlithotripsie (ESWL) neben der Ureterorenoskopie (URS) und der perkutanen Nephrolitholapaxie (PCNL) einen wesentlichen Behandlungspfeiler sowie die einzige nichtinvasive Behandlungsoption von Steinen im Harntrakt dar. Nach einer langen Phase der hohen Akzeptanz der ESWL sank in den letzten Jahren die Anzahl an ESWL-Interventionen zugunsten der beiden anderen Therapiemodalitäten (URS und PCNL). In diesem Artikel werden die Indikationen, die Operationstechnik und die Komplikationen sowie das Komplikationsmanagement des Eingriffs beschrieben.
Schlüsselwörter
Harnsteine Urolithiasis Steintherapie Operative Techniken Minimal-invasive TechnikenExtracorporeal shock wave lithotripsy
Abstract
Interventional treatment of stones essentially consists of three treatment modalities. Extracorporeal shockwave lithotripsy (ESWL), in addition to uterorenoscopy (URS) and percutaneous nephrolitholapaxy (PCNL) is an essential treatment pillar and is the only noninvasive therapy option for the treatment of urinary stones. After a long period of ESWL being the leading choice in stone treatment, the number of SWL interventions diminished in recent years in favor of the other two treatment modalities (URS and PCNL). This article describes the indications, surgical technique and management of complications of SWL.
Keywords
Urinary calculi Urolihiasis Stone treatment Surgical techniques Minimally invasive techniquesNotes
Einhaltung ethischer Richtlinien
Interessenkonflikt
J. Klein, C. Netsch, K.D. Sievert, A. Miernik, J. Westphal, H. Leyh, T.R.W. Herrmann, P. Olbert, A. Häcker, A. Bachmann, R. Homberg, M. Schoenthaler, J. Rassweiler und A. J. Gross geben an, dass kein Interessenkonflikt besteht.
Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.
Literatur
Verwendete Literatur
- 1.Türk C, Petrik A, Seitz C, Skolarikos A, Knoll T, Neisius A, Tepeler A (2017) EAU Guidelines on Urolithiasis (Guideline sssociates: Debestani S, Drake T, Grivas N, Ruhayel Y)Google Scholar
- 2.Knoll T, Bach T, Humke U, Neisius A, Stein R, Schönthaler M, Wendt-Nordahl G (2016) S2k-Leitliniezur Diagnostik, Therapie und Metaphylaxe der Urolithiasis (AWMF 043/025). Urologe A 55(7):904–922CrossRefPubMedGoogle Scholar
- 3.Tailly GG (2013) Extracorporeal shock wave lithotripsy today. Indian J Urol 29:200–207CrossRefPubMedPubMedCentralGoogle Scholar
- 4.Kroczak T, Scotland KB, Chew B, Pace KT (2017) Shockwave lithotripsy: techniques for improving outcomes. World J Urol. https://doi.org/10.1007/s00345-017-2056-y Google Scholar
- 5.Lam HS, Lingeman JE, Barron M et al (1992) Staghorn calculi: analysis of treatment results between initial percutaneous nephr-ostolithotomy and extracorporeal shock wave lithotripsy mono-therapy with reference to surface area. J Urol 147(5):1219–1225CrossRefPubMedGoogle Scholar
- 6.Wiesenthal JD, Ghiculete D, Ray AA et al (2011) A clinical nomogram to predict the successful shock wave lithotripsy of renal and ureteral calculi. J Urol 186:556–562CrossRefPubMedGoogle Scholar
- 7.Patel T, Kozakowski K, Hruby G et al (2009) Skin to stone distance is an independent predictor of stone-free status following shockwave lithotripsy. J Endourol 23:1383CrossRefPubMedGoogle Scholar
- 8.Gupta NP, Ansari MS, Kesarvani P et al (2005) Role of computed tomography with no contrast medium enhancement in predicting the outcome of extracorporeal shock wave lithotripsy for urinary calculi. BJU Int 95:1285–1288CrossRefPubMedGoogle Scholar
- 9.Joseph P, Mandal AK, Singh SK et al (2002) Computerized tomography attenuation value of renal calculus: can it predict successful fragmentation of the calculus by extracorporeal shock wave lithotripsy? A preliminary study. J Urol 167:1968–1971CrossRefPubMedGoogle Scholar
- 10.Albala DM, Assimos DG, Clayman RV et al (2001) Lower pole I: a prospective randomized trial of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy for lower pole nephrolithiasis-initial results. J Urol 166(6):2072–2080CrossRefPubMedGoogle Scholar
- 11.Platonov MA, Gillis AM, Kavanagh KM (2008) Pacemakers, implantable cardioverter/defibrillators and extracorporeal shockwave lithotripsy: evidence-based guidelines for the modern era. J Endourol 22:243–247CrossRefPubMedGoogle Scholar
- 12.Bohris C, Roosen A, Dickmann M et al (2012) Monitoring the coupling of the lithotripter head with skin during routine shock wave lithotripsy with a surveillance camera. J Urol 187:157–163CrossRefPubMedGoogle Scholar
- 13.Phipps S, Stephenson C, Tolley D (2013) Extracorporeal shockwave lithotripsy to distal ureteric stones: the transgluteal approach signi cantly increases stone-free rates. BJU Int 112:E129–E133CrossRefPubMedGoogle Scholar
- 14.Paterson R, Lifshitz DA, Lingeman JE et al (2002) Stone fragmentation during shock wave lithotripsy is improved by slowing the shock wave rate: studies with a new animal model. J Urol 168:2211–2215CrossRefPubMedGoogle Scholar
- 15.Jain A, Shah TK (2007) Effect of air bubbles in the coupling medium on efficacy of extracorporeal shock wave lithotripsy. Eur Urol 51(6):1680–1686CrossRefPubMedGoogle Scholar
- 16.Rassweiller JJ, Knoll T, Kohrmann KU, McAteer JA, Lingeman JE, Cleveland RO, Bailey MR, Chaussy C (2011) Shock wave technology and application: an update. Eur Urol 59(5):784–796CrossRefGoogle Scholar
- 17.Lingeman JE, McAteer JA, Gnessin E et al (2009) Shock wave lithotripsy: advances in technology and technique. Nat Rev Urol 6:660–670CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Paterson RF, Lifshitz DA, Kuo R et al (2002) Shock wave litho-tripsy monotherapy for renal calculi. Int Braz J Urol 28:291–301PubMedGoogle Scholar
- 19.Li K, Lin T, Zhang C et al (2013) Optimal frequency of shock wave lithotripsy in urolithiasis treatment: a systematic review and meta-analysis of randomized controlled trials. J Urol 190:1260–1267CrossRefPubMedGoogle Scholar
- 20.Gillitzer R, Neisius A, Wšllner J et al (2009) Low-frequency extracorporeal shock wave lithotripsy improves renal pelvic stone disintegration in a pig model. BJU Int 103:1284–1288CrossRefPubMedGoogle Scholar
- 21.Türk C, Knoll T, Seitz C et al (2017) Medical expulsive therapy for ureterolithiasis: the EAU recommendations in 2016. Eur Urol 71(4):504–507CrossRefPubMedGoogle Scholar
- 22.Patterson JM, Wiseman OJ (2017) The role of medical expulsive therapy for ureteral stones: against MET. Eur Urol Focus 3(1):5–6CrossRefPubMedGoogle Scholar
- 23.Knoll T, Türk C (2017) The role of medical expulsive therapy for ureteral stones: pro MET. Eur Urol Focus 3(1):3–4CrossRefPubMedGoogle Scholar
- 24.Skolarikos A, Ghani KR, Seitz C et al (2017) Medical expulsive therapy in urolithiasis: a review of the quality of the current evidence. Eur Urol Focus 3(1):27–45CrossRefPubMedGoogle Scholar
- 25.Schuler TD, Shahani R, Honey RJ et al (2009) Medical expulsive therapy as an adjunct to improve shockwave lithotripsy outcomes: a systematic review and meta-analysis. J Endourol 23:387–393CrossRefPubMedGoogle Scholar
- 26.Seitz C, Liatsikos E, Porpiglia F et al (2009) Medical therapy to facilitate the passage of stones: what is the evidence? Eur Urol 56:455–471CrossRefPubMedGoogle Scholar
- 27.Pace KT, Tariq N, Dyer SJ et al (2001) Mechanical percussion, inversion and diuresis for residual lower pole fragments after shock wave lithotripsy: a prospective, single blind, randomized controlled trial. J Urol 166(6):2065–2071CrossRefPubMedGoogle Scholar
- 28.Zhang W, Zhou T, Wu T et al (2015) Retrograde surgery versus percutaneous nephrolithotomy versus extracorporeal shockwave lithotripsy for treatment of lower pole renal stones: a meta-analysis and systematic review. J Endourol 29(7):745–759CrossRefPubMedGoogle Scholar
Weiterführende Literatur
- 1.Maxwell A, Cunitz B, Kreider W et al (2015) Fragmentation of urinary calculi in vitro by burst wave lithotripsy. J Urol 193(1):338–344CrossRefPubMedGoogle Scholar
- 2.Neisius A (2017) Hat die extrakorporale Stoßwellenlithotrispie noch einen Stellenwert? Urologe A 2017(56):1147–1157CrossRefGoogle Scholar