ČESKÁ UROLOGIE / CZECH UROLOGY – 2 / 2021

113 ORIGINÁLNÍ PRÁCE Ces Urol 2021; 25(1): 112–119 pritom sledujeme nutnosť využitia auxiliárnych postupov a počet intervencí ESWL nutných pre kompletnú sanáciu konkrementu Výsledky: Pri USG zameriavaní bola SFR na úrovni 90% Primerný počet intervencí 1,3 RTG‑ -fokusácia: kumulatívne skupina Sonolith-i-sys plus Medilit 7: bola zistená hodnota SFR 90% pri 1,5 dobách Signifikantný rozdiel v počte ESWL tak nebol zistený α = 0,105 Rovnaká situácia nastala pri porovnaní frekvencie prevedenia auxiliárneho postupu – zavedenia stentu alebo ureterorenos‑ kopie α = 0,453, zatiaľ čo pri kumulatívnej radiačej záťaži je rozdiel signifikantný, podobne ako v prí‑ pade potreby analgetika bola taktiež signifikanatne nižšia (α <0,001) u USG fokusácie Miera prezencie operatéra pri intervencii bola signifikantne väčšia u USG ramena Záver: Výsledky našej štúdie deklarujú rovno‑ cennost'oboch zobrazovacích modalít z hľadiska efektivity USG navigácia by mala byť predovšet‑ kým s ohľadom na odbúranie radiačnej záťaže pre pacienta preferovanou formou zameriavania konkrementov pri realizácii ESWL KĽÚCOVÉ SLOVÁ Efektivita, extrakorporálna litotrypsia rázovou vlnou, radiačná záťaž, ultrasonografia, urolitiáza SUMMARY Motolová M, Král M Ultrasound guidance ver‑ sus flouroscopic targeting of urolithiasis by extra‑ corporeal shock wave litotripsy Aim: Efficacy comparison of two localization techniques using ESWL – exclusively real time ul‑ trasound or fluoroscopy Demonstration of at least equivalence of both techniques To publisize the advantages of real-time ultrasound guidance to encourage more departments in develop of this modality Methods: This bicentric retrospective study compares stone free rates (SFRs) in three selected groups of patients with similar characteristics In‑ clusion criteria: ESWL as primary intervention for nephrolithiasis, proximal or prevesical urethero‑ lithiasis The definition of stone free was a patient without any residual stone or the absence of frag‑ ments ≥2mm The arm with exclusively real-time USG targeting of urolithiasis contains a group of 120 patients, using electromagnetic lithotripter – STORZ SLK between 02/2017–02/2020 The fluro‑ scopy-arm includes two groups: 72 patients, us‑ ing electroconductive lithotripters: Sonolith-i-sys (EDAP) between 04–10/2017 and 68 patients, by using electrohydraulic lithotripter Medilit 7 be‑ tween 01/2016–03/2017 Simultaneus evaluation of requisite for auxiliary techniques and number of sessions for complete stone-desintegration Results: SFR was 90% in the USG-guided group The avarage number of ESWL sessions was 1,3 SFR in the fluoroscopic arm: the group-Sonolith-i-sys plus the group Medilit 7 was 90% The avarage number of ESWL sessions was 1,5 These results were not significantly different α = 0,105 The same result is shown on comparson of frequency of requirement for auxiliary techniques – DJ-stent insertion/ureterorenoscopy α = 0,453 Radiation ex‑ posure was the biggest difference between tech‑ niques, as well as analgesics requirement which were significantly lower in USG arm ( α <0,001) The operator presence-time was significantly longer in USG – guided ESWL Conclusion: Our study shows efficacy equiva‑ lence of outcomes of both localization modalities Real-time USG guidance should be primarily used to reduce radation exposure for patients undergo‑ ing ESWL KEY WORDS Effectivity, extracorporeal shock wave lithotripsy, radiation exposure, ultrasonography, urolithiasis ……… ÚVOD Fluoroskopické zameriavnie lithiasy bolo po dlhé roky zlatým štandardom pri realizácii ESWL V po‑ sledných rokoch sa čoraz viac dostáva do popredia ultrasonografia USG sondy sa kontinuálne vyvíjajú, ponúkajú stále lepšiu rozlišovaciu schopnosť Spolu s prídatným softwérom a high-tech príslušenstvom