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Litotricia por ondas de choque extracorpóreas como tratamiento de los cálculos del conducto pancreático principal Extracorporeal shock- wave lithotripsy as a treatment of the calculi of the main pancreatic duct
Domingo Pérez González,Carlos Scorza Sánchez,Nancy de León Rubio,Hermidio Hernández Mulet
Revista Cubana de Cirugía , 2004,
Abstract: Las ondas de choque extracorpóreas se utilizan desde hace varios a os con buenos resultados en la fragmentación de cálculos vesiculares y de las vías biliares en pacientes seleccionados. Cuando los cálculos del conducto pancreático principal no pueden extraerse endoscópicamente está indicada esta variante no quirúrgica. Se presentan 4 pacientes del sexo masculino, entre 41 y 55 a os de edad, con antecedentes de alcoholismo y el diagnóstico de pancreatitis crónica con litiasis en el conducto principal, 3 de ellos con más de 1 cálculo, que recibieron ondas de choque generadas por el principio electromagnético. Todos fragmentaron. El paciente con cálculo único eliminó los fragmentos espontáneamente, mientras que en los 3 restantes fue necesario asociar la endoscopia para obtener la limpieza total de Wirsung . Durante el seguimiento de más de 5 a os se constató la regresión de los síntomas, fundamentalmente del dolor, sin recidivas The extracorporeal shock waves have been used for several years with good results in the fragmentation of calculi of the gallbladder and of the biliary tract in selected patients. When the calculi of the main pancreatic duct cannot be endoscopically removed, this non-surgical variant is indicated. 4 male patients aged 41-55 with alcoholism history and the diagnosis of chronic pancreatitis with lithiasis in the main duct are presented. 3 of them with more than a calculus received shock waves generated by electromagnetic principle. All the calculi were fragmented. The patient with only one calculus eliminated the fragments spontaneously, whereas in the other 3 it was necessary to associate endoscopy to obtain Wirsung's total cleaning. During the follow-up of more than 5 years it was proved the regression of the symptoms, mainly pain, without relapses
Criterios de selección para fragmentación de cálculos vesiculares por ondas de choque extracorpóreas Selection criteria for fragmenting gallstones by extracorporeal shock waves
Domingo Pérez González,Carlos Scorza Sánchez,Nancy De León Rubio,Hermidio Hernández Mulet
Revista Cubana de Cirugía , 2004,
Abstract: La fragmentación de cálculos vesiculares por ondas de choque extracorpóreas es otra de las variantes terapéuticas no quirúrgicas a tener en cuenta en esta entidad. Se estudiaron 1 957 pacientes remitidos de todo el país con el diagnóstico de litiasis vesicular en una consulta especializada creada el efecto en el Hospital Clínico Quirúrgico “Hermanos Ameijeiras”. Se seleccionaron 626 (32 %) y se siguieron inicialmente los criterios del Grupo de Munich; 479 (76,6 %) del sexo femenino y 147 (23,4 %) del masculino. En 125 pacientes (20,0 %) la edad sobrepasó los 60 a os. No se incluyeron 672 por componente litiásico grande (50,4 %); 276 por vesícula excluida en la colecistografía oral (20,8 %) y 212 por vaciamiento vesicular insuficiente (16,0 %). La hipertensión arterial (67,0), la diabetes melitus (45,0 %) y la cardiopatía isquémica (28,0 %) fueron las enfermedades asociadas más frecuentes en los seleccionados; en ellos predominaron los cálculos únicos (71,7 %), de hasta 20 mm de diámetro (65,7 %), radiotransparentes (83 %) y con densidades inferiores a las 50 unidades Houndsfield (60,5 %) The fragmentation of gallstones by extracorporeal shock waves is other of the nonsurgical threapeutic variants to be taken into account in this entity. 1 957 patients referred from all over the country with the diagnosis of biliary lithiasis were studied in a specialized office established to this end at “Hermanos Ameijeiras” Clinical and Surgical Hospital. 626 (32 %) were selected, 479 (76.6 %) females and 147 (23.4 %) males, and the criteria of the Group of Munich were initially followed. 125 patients (20.0 %) were over 60. 672 were not included due to large lithiasic component (50.4 %); 276 due to gallblader excluded in oral cholecistography (20,8 %); and 212 to insufficient gallblader dumping (16,0 %). Arterial hypertension (67,0 %), diabetes melitus (45,0 %) and ischemic heart disease (28.0 %) were the most frequent associated diseases among the selected individuals. The single calculi (71.7 %) of up to 20 mm of diameter (65.7 %), radiotransparent (83 %) and with densities under 50 Houndsfield units (60.5 %) predominated
Factores que influyen en la fragmentación de cálculos vesiculares por ondas de choque extracorpóreas Factors influencing on the fragmentation of gallbladder calculi by extracorporeal shock waves
Domingo Pérez González,Carlos Scorza Sánchez,Nancy de León Rubio,Hermidio Hernández Mulet
Revista Cubana de Cirugía , 2004,
Abstract: La litotricia por ondas de choque extracorpóreas es una de las variantes terapéuticas para la litiasis vesicular sintomática. Se aplicaron en 626 pacientes 479 (76,6 %) del sexo femenino y 147 (23,4 %) del masculino, con más de 40 a os de edad en 473 (69,9 %). Los índices de fragmentación completa fueron mayores en los pacientes con cálculos únicos (79,5 %), de menos de 20 mm de diámetro (72,3 %), radiotransparentes (89,2 %) y con densidades inferiores a las 50 unidades Houndsfield (72,6 %). Necesitaron 2, 3 y 4 sesiones de tratamiento 215 pacientes (34,3 %), 35 (5,6 %) y 11 (1,8 %) respectivamente. Finalmente la fragmentación fue completa en 332 (53,0 %), parcial en 241 (38,5 %) y solo no fragmentaron 53 (8,5 %), donde se demostró el valor de las características físicas e imagenológicas de los cálculos en este proceso Extracorporeal shock-wave lithotripsy is one of the therapeutic variants for symptomatic gallbladder lithiasis. It was applied to 626 patients, 479 (76.6 %) females and 147 (23.4 %) males. 473 (69.9 %) were over 40. The indexes of complete fragmentation were higher in patients with a single calculus (79.5 %) of less than 20 mm of diameter (72.3 %·), radiotransparent (89.2%) and with densities under 50 Houndsfield units (72.6 %). 215 patients (34.3 %), 35 (5.6 %) and 11 (1.8 %) needed 2,3 and 4 treatment sessions, respectively. Finally, the fragmentation was complete in 332 (53.0 %), partial in 241 (38.5 %) and only 53 (8.5 %) were not fragmented. The value of the physical and imaging characteristics of the calculi in this process was demonstrated
Experiencia en Cuba del tratamiento de la litiasis renoureteral con litotricia extracorpórea por ondas de choque en ni os Cuban experience in the treatment of renouretheral lithiasis in children by using extracorporeal shock wave lithotripsy
María Victoria Labrada Rodríguez,Enrique Larrea Masvidal,Mariano Castillo Rodríguez,Luis Borrero Barriento
Revista Cubana de Pediatr?-a , 2012,
Abstract: Introducción: la litiasis urinaria en el ni o resulta una enfermedad poco frecuente si se compara con su incidencia en el adulto. Objetivos: describir el resultado del tratamiento en Cuba de la litiasis del aparato urinario en ni os, mediante la litotricia extracorpórea por ondas de choque, así como validar la eficacia del método. Métodos: la muestra corresponde a 227 ni os, tratados en el Centro de Tratamiento de la Litiasis Urinaria del Hospital Clinicoquirúrgico "Hermanos Ameijeiras'' de La Habana, entre abril de 1986 y octubre de 2011, utilizando 3 tipos de litotritores: el HM3 (Dornier), Lithostar Plus (Siemens) y Medical Modulith SLX (Storz). Resultados: las edades límites fueron 2 y 18 a os. De manera general resultó similar el total de pacientes tratados del sexo femenino que el masculino (51 %/49 %). El síntoma predominante fue el cólico nefrítico con cálculos renales (81,9 %), y en el uréter (18,1 %). La superficie media fue de 1,20 cm2. Se utilizó anestesia general orotraqueal (34,4 %) y general intravenosa (65,6 %). Los retratamientos fueron necesarios en 8 casos (3,52 %). Las complicaciones fueron la infección urinaria aguda (3,08 %) y el hematoma subcapsular renal (0,88 %). Resultó libre de material litiásico el 96,04 %. Conclusiones: la terapéutica mediante la litotricia extracorpórea por ondas de choque resulta efectiva, con baja tasa de morbilidad y de complicaciones graves, por lo que creemos debe defenderse científicamente como la primera opción terapéutica en la resolución de la litiasis urinaria en estas edades. Debe recordarse que eliminar el cálculo no es suficiente, hay que identificar la enfermedad, su tratamiento de fondo, y evitar las recidivas. Introduction: urinary lithiasis is a rare disease in children if compared with its incidence on the adults. Objectives: to describe the results of the treatment of urinary lithiasis in children in Cuba, by using extracorporeal shock wave lithrotripsy, and to validate the efficacy of this method. Methods: a sample of 227 children treated at the Center of Urinary Lithiasis Treatment in "Hermanos Ameijeiras" hospital of Havana, Cuba, from April 1986 to October 2011. Three types of lithotripters were used: HM3 (Dornier), Lithostar Plus (Siemens) y Medical Modulith SLX (Storz). Results: the ages ranged from 2 to 18 years. The numbers of treated females and males were similar (51 % and 49 %). The prevailing symptom was nephritic colic with renal calculi (81.9 %) and in the urether (18.1 %). The mean affected surface was 1.20 cm2. General orotracheal(34.4 %) and general intravenous (65.6 %)
Litiasis única en vesícula doble tratada con ondas de choque extracorpórea Single lithiasis in double gallblader treated with extracorporeal shock waves
Domingo Pérez González,Carlos Scorza Sánchez,Nancy de León Rubio,Hermidio Hernández Mulet
Revista Cubana de Cirugía , 2004,
Abstract: La vesícula biliar doble es una anomalía congénita poco frecuente. Su diagnóstico puede realizarse con ultrasonido y colecistografía. Se presenta una paciente de 27 a os de edad, con antecedentes de intolerancia a las grasas y cólicos biliares a repetición, con vesícula duplicada; exteriormente fundida y dos conductos císticos independientes que desembocan en el hepatocolécodo, con un cálculo único, de 12 mm de diámetro, retrotransparente y 0 unidades Houndfield, ubicado en el cuello de la vesícula más desarrollada. Se aplicaron 2 259 ondas de choque extracorpóreas de 20,4 kilovoltios, generadas por el principio electromagnético; en una sesión de litroticia. Se detuvo fragmentación completa del cálculo. El tratamiento fue ambulatorio. La paciente se reincorporó a su vida laboral a las 24 horas. Durante la expulsión de los fragmentos tuvo varias crisis de dolor que cedieron con analgésicos orales. A los 6 meses, la vesícula afectada se encontraba libre de fragmentos y funcional. No existió complicación y hasta el momento se mantiene asintomática Double gall bladder is an uncommon congenital abnormality. It may be diagnosed by ultrasound and cholecystography. It is reported the case of a 27-year-old patient with history of intolerance to fats and repeated biliary cholics, with duplicated gallbladder externally fused, and two independent cystic ducts flowing to the hepatocholedoco with a single calculus of 12 mm of diameter, retrotransparent and 0 Houndfield units, located in the neck of the more developed gallbladder. 2 259 extracorporeal shock waves of 20.4 kilovolts generated by the electromagnetic principle were applied in a lithotripsy session. The complete fragmentation of the calculus was stopped. The treatment was ambulatory. The patient reincorporated to her working life at 24 hours. During the expulsion of the fragments, she had several pain crises that were resolved with oral analgesics. Six months later, the affected gallbladder was free of fragments. There has been no complication and she is asymptomatic so far
Tratamiento de la pseudoartrosis de la tibia mediante ondas de choque por litotricia extracorpórea
álvarez Cambras,Rodrigo; Rodríguez Vázquez,Matilde I; García Estrada,Elsa María; Marrero Riverón,Luis Oscar; Vega Rodríguez,Aliz M;
Revista Cubana de Ortopedia y Traumatolog?-a , 2004,
Abstract: two patients suffering from pseudoarthosis of the tibia for a long time, with previous unsatisfactory treatment including other methods were presented. the extracorporeal shockwave therapy results to be an effective therapeutical technique in each case. the clinical picture along with the previous and final imaging were set forth. a literature review was made.
Rotura yatrógena de uréter secundaria a litotricia extracorpórea por ondas de choque
Rodríguez Alonso,A.; Suárez Pascual,G.; González Blanco,A.; Bonelli Martín,C.; Lorenzo Franco,J.; Cuerpo Pérez,M.á.; Used Aznar,Ma.M.; álvarez Fernández,J.C.; Nieto García,J.;
Actas Urológicas Espa?olas , 2004, DOI: 10.4321/S0210-48062004000700007
Abstract: extracorporeal shock wave lithotripsy is the treatment of choice in most cases of urinary calculi, with the estimation that open surgery is only necessary in 5% of all cases. in most cases, the complications derived from this technique are slight, transitory and of little clinical importance, with isolated cases of serious urological or extraurological injury. these complications are either caused by the action of the stone itself or its fragments, or by the action of shock waves. we present a case of ureteral rupture following treatment of a ureteral calculus using extracorporeal shock wave lithotripsy which led to a periureteral retroperitoneal abscess that was treated by nephroureterectomy.
Historia de la litotricia por ondas de choque en Espa?a
Ruíz Marcellán,Francisco Javier; Ibarz Servio,Luis;
Archivos Espa?oles de Urología (Ed. impresa) , 2007, DOI: 10.4321/S0004-06142007000800019
Abstract: we give a historical outline of urinary lithiasis with emphasis in the alternative therapeutic options to surgery. we expose the previous steps that led to the birth of extracorporeal shockwave lithotripsy and its implementation in our country.
Tratamento conservador de trauma renal grave após litotripsia extracorpórea por ondas de choque
Marchini, Giovanni Scala;Lopes, Roberto Iglesias;Bruschini, Homero;Torricelli, Fábio;Lopes, Roberto Nicomedes;
Revista do Colégio Brasileiro de Cirurgi?es , 2011, DOI: 10.1590/S0100-69912011000600015
Abstract: subcapsular and perinephric hematomas are relatively common after shock-wave lithotripsy, but high-grade kidney injuries are extremely rare. we present the first case of a high-grade kidney injury after shock-wave lithotripsy managed conservatively. a 57-year-old white female patient with left 1.5cm superior ureteral calculi was submitted to shock-wave lithotripsy.
Hematomas renales tras Litotricia Extracorpórea por Ondas de Choque: LEOCH
Pastor Navarro,Héctor; Carrión López,Pedro; Martínez Ruiz,Jesús; Pastor Guzmán,José Ma; Martínez Martín,Mariano; Virseda Rodríguez,Julio A.;
Actas Urológicas Espa?olas , 2009, DOI: 10.4321/S0210-48062009000300013
Abstract: introduction: the use of fragmentation due to shock- waves as a treatment of urinary stone was one of the most important therapeutics findings in the history of urology. it′s the first election treatment for most of the calculus at renal and urethral location due to the fact that it is a low invasive treatment and it has a few number of complications, but this method also has a few negative side effects, it can caused a more or less important traumatic lesion at the organs which crosses the shock- waves, including the kidney where it can caused a small contusion or renal hematoma with different resolution and treatment. material and method: we reviewed 4815 extracorporeal shock-wave lithotripsy that we performed in our department in which we found six cases with subcapsular and perirrenal hematoma which we followed up and treated. results: after the urological complications (pain, obstruction and infection) the renal and perirrenal hematic collections are the most frequent adverse effects of shock- waves used in lithotripsy, these are related to the power of energy used and patient age. conclusions: between the years 1992-2007 we performed 4.815 extracorporeal shock-wave lithotripsy finding seven cases of severe hematoma, less then 1%.treatment of these complications is usually not aggressive though sometimes it is necessary to perform surgical drainage and even nephrectomy.
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