Is a CT KUB on the day of surgery for ureteric stones effective from a clinical and organisational perspective?
BAUS ePoster online library. Smekal M. 06/25/19; 259480; P11-6
Martina Smekal
Martina Smekal
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Abstract
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Introduction:
A CT KUB on the day of surgery for patients with ureteric stones but without renal calculi helps reduce pre-operative imaging and avoids a possible 'negative ureteroscopy'. We aimed to evaluate the effectiveness of on the day CT KUB for scheduled patients and for its potential to cause theatre under-utilisation.

METHODS:

We retrospectively audited patients with ureteric stones listed for planned ureteroscopy in a dedicated stone and endourology theatre, between 01/08/2016 and 31/08/2018, reviewing on the day imaging to determine who had already passed their stones by the day of surgery. We then analysed theatre utilisation reports on the days where a ureteroscopy was cancelled due to CT-confirmed passage of ureteric stone.

Results:

30% (20/67) patients audited had passed their stone by the day of the procedure, occurring over 17 theatre lists. Additional emergency / un-planned procedures took place on 15 out of 17(88%) of these lists during which a total of 21 emergency/unplanned procedures were performed. The most common emergency procedures were nephrostomy-related and cystoscopic insertion of ureteric stents (9 and 6 cases respectively). However, 4 primary ureteroscopies for acute ureteric colic patients were also performed.

Conclusion:
A Low dose CT KUB on the day for elective patients avoids an unnecessary general anaesthetic and negative ureteroscopy whilst creating theatre capacity for emergency patients. This benefits the scheduled patient and allows the possibility for definitive treatment for emergency patients as per recent GIRFT and NICE guidance.
Introduction:
A CT KUB on the day of surgery for patients with ureteric stones but without renal calculi helps reduce pre-operative imaging and avoids a possible 'negative ureteroscopy'. We aimed to evaluate the effectiveness of on the day CT KUB for scheduled patients and for its potential to cause theatre under-utilisation.

METHODS:

We retrospectively audited patients with ureteric stones listed for planned ureteroscopy in a dedicated stone and endourology theatre, between 01/08/2016 and 31/08/2018, reviewing on the day imaging to determine who had already passed their stones by the day of surgery. We then analysed theatre utilisation reports on the days where a ureteroscopy was cancelled due to CT-confirmed passage of ureteric stone.

Results:

30% (20/67) patients audited had passed their stone by the day of the procedure, occurring over 17 theatre lists. Additional emergency / un-planned procedures took place on 15 out of 17(88%) of these lists during which a total of 21 emergency/unplanned procedures were performed. The most common emergency procedures were nephrostomy-related and cystoscopic insertion of ureteric stents (9 and 6 cases respectively). However, 4 primary ureteroscopies for acute ureteric colic patients were also performed.

Conclusion:
A Low dose CT KUB on the day for elective patients avoids an unnecessary general anaesthetic and negative ureteroscopy whilst creating theatre capacity for emergency patients. This benefits the scheduled patient and allows the possibility for definitive treatment for emergency patients as per recent GIRFT and NICE guidance.
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