[Development of the indications for extra-corporeal lithotripsy and the impact of organizational methods on the indications].
A technology assessment of ESWL for renal stones has been conducted. The development of lithotripsy during the early phase of diffusion of the technique was studied retrospectively for 1985 and 1986. This study permitted the comparison of lithotripsy practice in Paris with that in Lyon. Results show that the proportion of small (less than 10 mm) stones increased from 39% at the beginning of the period to 60% at the end in Paris and simultaneously from 41% to 53% in Lyon. The location of the calculi treated by ESWL changed significantly over the period, but only in Paris where the number of caliceal stones went from 62% to 38% and that of ureteral stones from 1% to 8%. Neither the number of stones treated during one ESWL session, nor the length of hospital stay, changed significantly during the first years of use of this treatment. However, if one excludes hospital stays of more than 15 days, the average hospital stay in Paris decreased where as the opposite was observed in Lyon. The impact of the organization of ESWL users upon medical practice is obvious in relation to the size of stones: in Lyon, where one team provides ESWL therapy for all hospital urology departments, treatment practice is more homogeneous than in Paris and more closely a resembles the international consensus.
Viens-Bitker
C
C
Service Evaluation des Technologies Nouvelles, Paris.
de Pouvourville
G
G
Poulin
D
D
Morgon
E
E
Blum-Boisgard
C
C
D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000453:epidemiology* / Q000628:therapy; D008096:Lithotripsy / Q000706:statistics & numerical data* / Q000639:trends; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013673:Technology Assessment, Biomedical
Evolution des indications de la lithotripsie extra-corporelle et impact du mode d'organisation sur les indications.