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Li Y, Lv J. Effect of external physical vibration lithecbole in obese patients with lower pole stones <15 mm after ESWL: a single-centre, randomized, open label clinical trial. Front Med (Lausanne) 2023; 10:1101811. [PMID: 37711736 PMCID: PMC10498918 DOI: 10.3389/fmed.2023.1101811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 08/16/2023] [Indexed: 09/16/2023] Open
Abstract
Objective To investigate the efficacy and safety of external physical vibration lithecbole (EPVL) in obese patients with <15 mm lower pole stones following extracorporeal shock wave lithotripsy (ESWL). Methods Two hundred and ninety-nine obese patients with BMI greater than 30 kg/m2 and lower pole stones smaller than 15 mm were prospectively randomized into two groups. While ESWL was the only option in the control group, patients in the treatment group accepted EPVL after receiving ESWL. Imaging tests were used to compare the stone expulsion status on day 1 and the stone-free rates (SFR) on the first, second, and fourth weekends. Results All 299 obese patients were randomly divided into two groups, with 152 patients assigned to the treatment group and 147 assigned to the control group. EPVL was effective in facilitating the expulsion of stone fragments. The treatment group's stone expulsion rate on the first day following EPVL was significantly greater than the control group's (66.4% vs. 51.7%, p = 0.009). Stone clearance rates in the treatment and control groups were 63.2 and 55.1% at 1 week (p = 0.041), 84.9 and 70.7% at 2 weeks (p = 0.011), and 90.8 and 79.6% at 4 weeks (p = 0.017), respectively. The complications (hematuria, lumbago, and fever) between the groups did not show any significance (p > 0.05). Patients in the treatment group received an average of 5.2 sessions. Conclusion EPVL is an efficient and secure procedure that facilitates lower pole stone discharge in obese patients following ESWL treatment. To support the aforementioned conclusions, additional large-scale multi-center prospective studies are required.
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Affiliation(s)
- Yunpeng Li
- Department of Urology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
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Yang T, Song R, Meng X, Wei H, Jiang X, Yuan X, Liu X, Jiao Z, Liu J, Shi H. A single center study that evaluates the preclinical use of a newly developed software and moving bed system to facilitate the spontaneous excretion of residual fragments after primary stone treatment (RIRS or PCNL). World J Urol 2021; 40:585-591. [PMID: 34687345 PMCID: PMC8921061 DOI: 10.1007/s00345-021-03863-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/07/2021] [Indexed: 11/27/2022] Open
Abstract
Purpose We developed a Postural Drainage Lithotripsy System (PDLS) that uses the patient's computed tomography urography (CTU) data to reconstruct the three-dimensional figure of the renal pelvis, provides an individualized inversion and overturning angle and uses gravity to remove residual fragments (RFs). The purpose of this study was to investigate PDLS in the treatment of renal RFs. Methods A stone with a diameter of 4.0 mm was placed in the upper, middle, and lower calyx of the renal model. A total of 60 trials were applied to 20 renal models. The movement trajectory, passage rate, and postural drainage angle of calculi during the treatment of PDLS were observed. Results All of the stones in 60 trials were observed to move during treatment, and 53/60 (88%) were relocated successfully to the renal pelvis. The passage rate of the upper calyx was 14/20 (70%), that of the middle calyx was 20/20 (100%), and that of the lower calyx was 19/20 (95%). Conclusions PDLS can provide individualized inversion and reversal angles and remove stones from the renal model. More clinical trials are needed to verify the above view and evaluate its efficacy. Supplementary Information The online version contains supplementary material available at 10.1007/s00345-021-03863-7.
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Affiliation(s)
- Tao Yang
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China.,Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
| | - Rijin Song
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xianghu Meng
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China.,Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Hanping Wei
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China.,Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
| | - Xinying Jiang
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China.,Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
| | - Xiaoliang Yuan
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China.,Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
| | - Xiaowu Liu
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China.,Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
| | - Zhimin Jiao
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China.,Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
| | - Jun Liu
- Department of Urology, The 940th Hospital of PLA Joint Logistics Support Force, Lanzhou, 730050, China
| | - Honglei Shi
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China. .,Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China.
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