Comparison Of Extracorporeal Shock Wave Lithotripsy Versus Ureteroscopic Stone Extraction In The Treatment Of Ureteral Stones

Aim: There are some controversies on the effectiveness of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic stone extraction (URS) in ureteral stones. Because, previous studies on this topic mostly included lower ureteral stones, we aimed to compare effectiveness of these two methods in both lower and upper ureteral stones. Method : After diagnosis of urolithiasis, ESWL or URS was performed to patients. Stone-free ratio, complications and necessity of an additional intervention for both procedures were recorded. The decision about the selection of method was made based on the patients′ choice. Upper and lower ureteral stones were included, while middle ureteral stones were excluded from the study. Result : Total number of patients undergone URS was 90 and ESWL was 96. There was no difference in male/female ratio, age and stone diameters between two groups (P>0.05). Upper ureteral stones were found to be more frequent in ESWL group than those in URS group (55.2% vs. 33.3%, respectively, P=0.004). Total stone-free ratio was 97.8% for URS and 68.8% for ESWL (P< 0.001). Ratios of treatment failures and complications were found to be lower in URS group compared with ESWL group (P< 0.05). Conclusion : Although, URS seems to be more successful in the treatment of ureteral stones, further prospective studies with more patients are needed to clarify our results

Low educational status and childhood obesity associated with ınsufficient mid-term weight loss after sleeve gastrectomy: A retrospective observational cohort study

Successful weight loss after bariatric surgery has been associated with a variety of factors. The aim of this study was to determine the effects of educational status on surgical weight loss for patients undergoing sleeve gastrectomy (SG). This retrospective cohort study was carried out on patients undergoing SG between September 2013 and July 2015. Six months after surgery, the patients were classified into two groups according to their success in the percentage of excess weight loss (%EWL). Group 1: =%50EWL (successful WL) in the sixth month. The independent predictors for insufficient weight loss six months after SG were analyzed. In the sixth post-operative month, their mean %EWL and percentage of excess body mass index loss (%EBMIL) were 50 +/- 15.4 and 58.2 +/- 19.3, respectively. In univariate analysis, group 1 patients were found to be significantly older when compared to group 2 patients while the education level of group 2 patients was significantly higher when compared to group 1. A tertiary educational level at a university or higher was associated with a nearly fourfold increased success in weight loss (AOR 3.772, p = 0.03) 6 months after SG. Multivariate analysis showed that patients with a history of childhood obesity were more likely to have insufficient weight loss (AOR 0.390, p = 0.045). Childhood obesity and a lower level of education are associated with insufficient weight loss 6 months after SG. However, prospective external validation is warranted, with a long-term follow-up of a large bariatric surgery population