Efficacy Comparison between Laser Lithotripsy (LL) and Pneumatic Lithotripsy (PNL) for Distal Ureteric Calculi - การเปรียบเทียบผลของการรักษานิ่วในท่อไตส่วนปลายโดยใช้พลังงานเลเซอร์และพลังงานลมอัดกระแทก

Abstract

The objective of this study was to compare the efficacies and complications of Laser Lithotripsy
(LL) and Pneumatic Lithotripsy (PNL) in the treatments of distal ureteric calculi by
ureterorenoscopic techniques for patients admitted to the hospital in a prospective randomized
controlled trial. They underwent either control trial ureterorenoscopic technique auxillary with
ureteric fragmentation Laser Lithotripsy (LL) or Pneumatic Lithotripsy (PNL) depending on surgical
indications. Patients were all randomized by labeled case by case, proceeded to under go surgical
procedure either by spinal or general anaesthesia. Statistical analyse of surgical results were conducted
by comparing of stone free rates and complications of both surgical techniques.
From May 31, 2012 to January 7, 2013, 84 patients were enrolled into this study. While 42
patients underwent Laser Lithotripsy and the others 42 patients with Pneumatic Lithotripsy. Overall
efficacy of both techniques in stone free rate were not statistically different 97.62 percent of Laser
Lithotripsy and 92.86 percent by Pneumatic Lithotripsy. Nevertheless complications of Pneumatic
Lithotripsy were higher in multiple aspects of 19.05 percent stone retropulsion, 21.43 percent requiring
auxillary introduced double - J ureteric stent insertion, 2.38 percent urosepsis and 2.38 percent
incidentally sustained severe postoperative pain.
In conclusion, Laser Lithotripsy and Pneumatic Lithotripsy were not different in efficacy of
stone fragmentation but serious complications were found higher in the Pneumatic Lithotripsy group.
Key words: Laser Lithotripsy, Pneumatic Lithotripsy, distal ureteric calculi, ureterorenoscopy