[Extracorporeal lithotripsy in children. Study of its efficacy and evaluation of renal parenchymal damage by DMSA-Tc 99m scintigraphy: a series of 39 children].
OBJECTIVE
The objectives of the study were to confirm the efficacy of extracorporeal shock wave lithotripsy (ESWL) in infants and children and to evaluate potential long-term renal parenchymal damage by 99m Tc DMSA renal scan.


METHODS
Between November 1989 and November 1997, 39 children between 10 months and 17-1/2 years of age (average: 7 years) were treated by extracorporeal shock wave lithotripsy for kidney or ureteral stones with a Sonolith 3000 lithotriptor (Technomed Corp). Forty-six stones were treated. Eight metabolic and 11 urological abnormalities were identified. The evaluation of the treatment and its consequences were based on a clinical examination, conventional imaging and a DMSA renal scan performed 24 h before extracorporeal shock wave lithotripsy and at least 6 months after treatment.


RESULTS
Treatment was successful (stone fragmented and eliminated) in 84.6% at 3 months after one to four sessions. Sixty-one sessions were necessary and two patients underwent open surgery for failed extracorporeal shock wave lithotripsy. Three recurrences were also retreated. At long term follow-up (6 months to 8 years) no incidents of high blood pressure were observed, nor parenchymal lesions imputable to extracorporeal shock wave lithotripsy.


CONCLUSIONS
The efficacy of the extracorporeal shock wave lithotripsy for children is proven. This study also confirms the innocuousness of extracorporeal shock wave lithotripsy for renal parenchyma even in infants. However, long term follow-up and further evaluation with the other categories of lithotriptors are necessary to make definitive conclusions.
Traxer
O
O
Service de chirurgie urologique pédiatrique, fondation hôpital Saint-Joseph, Paris, France.
Lottmann
H
H
Archambaud
F
F
Helal
B
B
Mercier-Pageyral
B
B
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007668:Kidney / Q000293:injuries*; D008096:Lithotripsy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D016896:Treatment Outcome; D014545:Urinary Calculi / Q000628:therapy*; D014947:Wounds and Injuries / Q000000981:diagnostic imaging / Q000209:etiology
D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid