TY - JOUR
T1 - Morbidity associated with surgical treatment of ureteric calculi in a teaching hospital in Kuwait
AU - Kehinde, E. O.
AU - Al-Awadi, K. A.
AU - Al-Hunayan, A.
AU - Okasha, G. H.
AU - Al-Tawheed, A.
AU - Ali, Y.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2003/9
Y1 - 2003/9
N2 - Background: Ureteric lithiasis is a common urological problem in Kuwait. Because of the different interventional approaches, we carried out an audit on the morbidity associated with the surgical management of the disorder. Patients and methods: The surgical records were reviewed of all patients with the diagnosis of ureteric lithiasis that were managed surgically by ureteroscopy or ureterolithotomy in Mubarak Al-Kabeer Hospital in Kuwait between January 1996 and December 1999. Patients' bio-data, location of calculi, indications for surgical intervention, types of therapeutic interventions, operating surgeon and complications were analysed. Patients managed primarily and successfully by extracorporeal Shockwave lithotripsy were excluded from this analysis. Results: A total of 1383 patients with ureteric calculus were managed in the period under review - 775 (56%), 567 (41%), and 41 (3%) patients were managed by extracorporeal Shockwave lithotripsy, ureteroscopy and ureterolithotomy, respectively. The 608 patients managed by ureteroscopy or ureterolithotomy had a total of 710 operations. The commonest surgical procedure performed was ureteroscopy with Dormia basket with or without double 'J' stenting and this accounted for 418 (58.9%) operations. The least common procedure was ureteric meatotomy with Dormia basket and with or without double 'J' stenting in 9 (1.3%) patients. The overall complication rate was 110 out of 710 (15.5%) operations. Of the complications, 101 (92%) were minor (e.g. haematuria, fever, and mucosal injury). Nine (8%) complications were major complications (e.g. ureteric perforation and ureteric avulsions). Ureterolithotomy and ureteroscopy with intracorporeal lithotripsy were associated with the highest complication rates. Conclusions: This analysis has shown that with technological advances, the treatment of ureteric lithiasis has improved and major complications have decreased. However, with so many therapeutic options to choose from, there is a need to audit the various therapeutic options and select those associated with the least morbidity rates in each urology unit.
AB - Background: Ureteric lithiasis is a common urological problem in Kuwait. Because of the different interventional approaches, we carried out an audit on the morbidity associated with the surgical management of the disorder. Patients and methods: The surgical records were reviewed of all patients with the diagnosis of ureteric lithiasis that were managed surgically by ureteroscopy or ureterolithotomy in Mubarak Al-Kabeer Hospital in Kuwait between January 1996 and December 1999. Patients' bio-data, location of calculi, indications for surgical intervention, types of therapeutic interventions, operating surgeon and complications were analysed. Patients managed primarily and successfully by extracorporeal Shockwave lithotripsy were excluded from this analysis. Results: A total of 1383 patients with ureteric calculus were managed in the period under review - 775 (56%), 567 (41%), and 41 (3%) patients were managed by extracorporeal Shockwave lithotripsy, ureteroscopy and ureterolithotomy, respectively. The 608 patients managed by ureteroscopy or ureterolithotomy had a total of 710 operations. The commonest surgical procedure performed was ureteroscopy with Dormia basket with or without double 'J' stenting and this accounted for 418 (58.9%) operations. The least common procedure was ureteric meatotomy with Dormia basket and with or without double 'J' stenting in 9 (1.3%) patients. The overall complication rate was 110 out of 710 (15.5%) operations. Of the complications, 101 (92%) were minor (e.g. haematuria, fever, and mucosal injury). Nine (8%) complications were major complications (e.g. ureteric perforation and ureteric avulsions). Ureterolithotomy and ureteroscopy with intracorporeal lithotripsy were associated with the highest complication rates. Conclusions: This analysis has shown that with technological advances, the treatment of ureteric lithiasis has improved and major complications have decreased. However, with so many therapeutic options to choose from, there is a need to audit the various therapeutic options and select those associated with the least morbidity rates in each urology unit.
KW - Morbidity
KW - Surgical audit
KW - Ureteric calculi
KW - Ureterolithotomy
KW - Ureteroscopy
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U2 - 10.1308/003588403769162477
DO - 10.1308/003588403769162477
M3 - Article
C2 - 14594540
AN - SCOPUS:0141719325
VL - 85
SP - 340
EP - 346
JO - Annals of the Royal College of Surgeons of England
JF - Annals of the Royal College of Surgeons of England
SN - 0035-8843
IS - 5
ER -