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Biomedical subjects

C Chaussy

Publications and source records attributed to C Chaussy.

At least 37 records · Page 2Linked to original sources
PubMed1989

Short-term changes of laboratory values after extracorporeal shock wave lithotripsy: a comparative study.

Since the inception of extracorporeal shock wave lithotripsy 9 years ago treatment strategies have changed. Patients currently are receiving larger numbers of higher voltage shock waves. However, upper limits of safety for these treatments have not been established. In an attempt to address this question a comparative study of effects of extracorporeal shock wave lithotripsy on laboratory values between 2 stone centers, Munich and Tucson, using different treatment strategies 3 to 4 years apart was done to identify possible differing effects. Patient stone burdens were similar. However, Tucson patients received almost twice the number of shock waves. Both groups showed a significant decrease in hematocrit (by 8.7 per cent in Munich and 6.4 per cent in Tucson). Both groups had a significant increase in white blood count (14.5 per cent in Munich and 22.7 per cent in Tucson). In addition, both groups had increased serum levels of glutamic oxaloacetic transaminase of 43.3 and 59.7 per cent, respectively. However, only the Tucson group showed increases in serum glutamic pyruvic transaminase, lactic dehydrogenase and total bilirubin in 51.5, 40.8 and 46 per cent of the patients, respectively. Further analysis indicated that extracorporeal shock wave lithotripsy was associated with 2 significant short-term changes of blood or serum laboratory values: 1) those presumed to be dilutional from related infusions, rather than extracorporeal shock wave lithotripsy treatments themselves and 2) those presumed to be related to cellular injury after high energy treatments. Elevated serum glutamic pyruvic transaminase, lactic dehydrogenase and total bilirubin values of Tucson patients clearly were related to higher kilovolts and number of shocks or to treatments on the right side.(ABSTRACT TRUNCATED AT 250 WORDS)

Arizona↗
PubMed1989

[Extracorporeal shock wave lithotripsy: the evolution of a revolution].

Extracorporeal shockwave lithotripsy has now been in clinical use for 8 years, and it has replaced other treatment techniques for the majority of surgical calculi in the upper urinary tract. For the first time it provides a completely noninvasive method for the treatment of renal and ureteral calculi. The current range of indications means that approximately 70% of nonselected urinary stone patients can be treated by this method, while 25% of the patients with more complex stones in the upper urinary tract can receive treatment with the lithotripter combined with endourological procedures. The clinical role of this method is determined by a high success rate and minimal complications. This has led to a rapid worldwide acceptance in the urological community, and up to now more than 1.5 million patients with urinary stone disease have been treated.

Combined Modality Therapy↗
PubMed1989

[Prevalence and incidence of arterial hypertension in patients with kidney calculi treated by extracorporeal shock wave lithotripsy].

Follow-up studies were conducted on 806 patients to investigate the question of whether or not arterial hypertension can develop subsequent to ESWL. First of all, it was determined that 509 of 518 patients who were subjected to ESWL treatment from December 1985 to December 1986 still had normotension (n = 410) or hypertension (RR greater than or equal to, 160/95, n = 99) prior to and on an average of 9.3 months after ESWL. Six hypertensive patients became normotensive subsequent to ESWL. Only 1 patient developed hypertension following ESWL. Secondly, the 288 patients who were subjected to ESWL treatment from May 1982 to May 1984 revealed a 3.1% incidence of arterial hypertension within a period of 3.6 years following ESWL. This incidence, however, only illustrates that there was a pronounced age-related increase in the prevalence of hypertension (0.8% per year) in these study groups.

Adult↗
PubMed1989

[Long-term experiences following extracorporeal shockwave lithotripsy in patients with urinary calculi].

A report is given on the experience we have had over a period of up to 7 years following ESWL treatment in urinary stone patients. 131I-hippuran clearance studies were conducted on 19 patients prior to and 6.6 years subsequent to ESWL. There was no evidence of any degree of deterioration in total renal function or of any form of dysfunction in the kidney treated. Follow-up examinations on 247 patients showed a 7% recurrent stone rate within a period of 3.6 years following ESWL. In 16% of the cases, residual concretions were found 6 months after ESWL, only 4% of which were larger than 5 mm in diameter. In 22%, concretions were discovered 3.6 years after ESWL 36% of which were larger than 5 mm. This size increase in the fragments accounts for the stone growth.

Adult↗
PubMed1987

Transurethral ultrasonic ureterolithotripsy using a solid-wire probe.

A multicenter study evaluates a new technique for transurethral ultrasonic ureterolithotripsy utilizing a solid-wire probe. The transverse vibrations of the probe cause greater stone disintegration. A small ureteroscope is used and a basket is not required. There was a 96.6 per cent success rate in 118 cases. This technique has significantly improved ultrasonic lithotripsy. It has proved to be useful for upper ureteral stones not amenable to extracorporeal shock-wave lithotripsy and lower ureteral stones including "steinstrasse."

Evaluation Studies as Topic↗
PubMed1986

Extracorporeal shock wave lithotripsy.

Urolithiasis represents the symptomatic manifestation of various metabolic disturbances which persist after elimination of the immediate problem, i.e., urinary stones, and may lead to the development of recurrent stones. Invasive surgical removal of recurrent stones is sometimes associated with considerable problems. Against this backdrop it is not surprising that after development (1974-1980) and clinical testing (1980-1982) at the Department of Urology of the Ludwig Maximilian University in Munich, a meanwhile clinically proven method of totally noninvasive extracorporeal lithotripsy (ESWL) has disseminated within a relatively short time (from October 1983), first in West Germany (April 1986: 20 ESWL centers) and later all over the world (April 1986: 133 ESWL centers). With the advent of ESWL and semiinvasive techniques of stone extraction (percutaneous lithotripsy, ureterorenoscopy) a transformation of the therapeutic strategy for urolithiasis has been ushered in.

Adolescent↗
PubMed1986

[Extracorporeal lithotripsy in the treatment of renal lithiasis. 5 years' experience].

The historical background to extracorporeal lithotripsy using shock waves is described and indications for use of this treatment discussed in relation to other types of therapy for reno-ureteral lithiasis: percutaneous or trans-ureteral endoscopy. The reduction in invasive surgical procedures is emphasized. The first human use of extracorporeal lithotripsy by shock waves dates back to 1980. Since then, more than 30,000 calculi have been treated in this way, either exclusively or in combination with other therapy. For simple small calculi (less than 1 cm in diameter and situated in the pelvis or a calyx) the incidence of complications is minimal: renal colic (15%), fever (13%), need for complementary therapy (7%). With extension of use of extracorporeal lithotripsy to complex calculi (multiple calculi, staghorn calculi) these figures increased to 30, 5 and 12% respectively. Patients with obstructive and infected lithiasis were treated by percutaneous drainage nephrostomy with intensive antibiotic therapy prior to extracorporeal treatment. Extending indications also provided data on contraindications: coagulation disorders, major vascular problems, abnormal size or weight of patient, pregnancy and finally difficulty in localizing calculi. Of interest is the almost total lack of efficacy of shock waves for treating staghorn calculi. Treatment in these cases should be by an initial percutaneous approach to reduce size of calculus followed by extracorporeal lithotripsy under nephrostomy cover. Surgery for lithiasis should therefore be reserved for complex lithiasis cases with large caliceal calculi proximal to a long narrow infundibulum and to calculi proximal to a stenosis of pyelo-ureteral junction. Whenever possible, lumbar ureter calculi should be raised towards the pelvis by endoscopic manipulation before extracorporeal lithotripsy.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1985

The use of neodymium-YAG lasers in urology: indications, technique and critical assessment.

After development and experimental approval of suitable equipment for endoscopic and external use, the neodymium-YAG laser has been used routinely to treat tumors of the bladder and external genitalia in our department. A 2-year followup of 60 patients revealed a significant decrease in local bladder tumor recurrence (5 per cent). Successful laser therapy also was applied in cases of stage T1/T2 penile carcinomas, female urethral carcinomas and condylomata acuminata. Laser application offers an additional useful therapeutic procedure in the treatment of urological malignancies.

Animals↗
PubMed1985

[Experience with extracorporeal shockwave lithotripsy based on 5 years' clinical use].

After 6 years of experimental research at the Departments of Urology and Surgical Research of the Ludwig-Maximilian University in Munich, extracorporeal shock-wave lithotripsy (ESWL) was introduced into clinical use in 1980. Uniquely successful and increasingly requested by stone patients, the method soon became widespread. Currently more than 70 lithotriptors are in operation worldwide and over 30,000 treatments have been carried out successfully. Clinical experience in all centers has proved the safety, reliability and reproducibility of the method. Currently, approximately 70% of nonselected stone patients are eligible to receive ESWL treatment and, when combined with endourological procedures, more than 95% of patients can benefit from this method and thus avoid open surgery.

Adolescent↗
PubMed1984

Extracorporeal shock-wave lithotripsy (ESWL) of kidney and ureteric stones.

A noninvasive method for the treatment of urolithiasis is described. By means of focussed shock waves generated outside the body, stones in the lower urinary tract are destroyed and rendered fit for spontaneous discharge. Thereby the number of operations, as well as the recurrence rate are substantially reduced.

Adult↗
PubMed1984

Extracorporeal shock wave lithotripsy (ESWL) for kidney stones. An alternative to surgery?

Four years of experience with extracorporeal shock wave lithotripsy (ESWL) for renal and ureteral calculi is summarized. Ninety-nine percent of treated patients had a satisfactory clinical result; 90% of them were stone-free. No significant complications were encountered. We conclude that 85% of all patients with stones can be cured by nonsurgical means. Surgical and other therapeutic modalities will still have a place in the future, but an experienced urologic surgeon can best decide which of the available therapies is best suited for an individual patient.

Anesthesia↗
PubMed1984

Extracorporeal shock-wave lithotripsy of kidney and ureteric stones.

Extracorporeal shock-wave lithotripsy (ESWL) has become a routine therapy for the management of stone patients at our department. Till now ESWL has been performed on 1,000 patients. Although the indications for this noninvasive treatment have been expanded significantly, 90% of the patients have been stone free after treatment, 9.3% have small remaining stone particles, while only 0.7% have to be operated on. There was no alteration of kidney function after treatment. ESWL has proven to be a safe alternative to surgical stone removal within an increasing indication range.

Humans↗