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- Title
Ultrasonography Is Not Inferior to Fluoroscopy to Guide Extracorporeal Shock Waves during Treatment of Renal and Upper Ureteric Calculi: A Randomized Prospective Study.
- Authors
Van Besien, Jeroen; Uvin, Pieter; Hermie, Isabeau; Tailly, Thomas; Merckx, Luc
- Abstract
Objective. To investigate whether the visualization modality (ultrasound or fluoroscopy) used during shockwave lithotripsy (SWL) affects the clinical outcome in those instances where both imaging modalities are optional. Methods. Between November 2014 and July 2016, 114 patients with radiopaque upper urinary tract calculi were randomly assigned to an ultrasound- or fluoroscopy-guided SWL group in a prospective, open-label, single-center study. A standardized SWL protocol was used. The stone-free rate and the positive outcome rate (stone-free or asymptomatic residual fragments ≤ 4 mm) were compared. Results. The stone-free rate was 52% in the ultrasound-guided group compared to 42% in the fluoroscopy-guided group (p = 0.06) and the positive outcome rate was 79% in the ultrasound-guided group compared to 70% in the fluoroscopy-guided group (p = 0.28). These results were not significantly different but proved to be noninferior based on a Wilson confidence interval of independent proportions (noninferiority limit 10%). The mean number of SWL sessions was not significantly different (p = 0.4). Conclusion. Our study demonstrated that the clinical results of ultrasound-guided SWL were not inferior to the results of fluoroscopy-guided SWL, while no ionizing radiation is needed.
- Subjects
TREATMENT of calculi; URINARY calculi; ULTRASONIC imaging -- Evaluation; TREATMENT effectiveness; FLUOROSCOPY; LITHOTRIPSY; LONGITUDINAL method; EVALUATION of medical care; RANDOMIZED controlled trials; THERAPEUTICS
- Publication
BioMed Research International, 2017, Vol 2017, p1
- ISSN
2314-6133
- Publication type
Article
- DOI
10.1155/2017/7802672