Improving secondary care pathway for patients with ureteric colic: Feasibility and outcome of primary ureteroscopy in emergency theatre at a large district general hospital
BAUS ePoster online library. Wong K. Jun 25, 2019; 259473; P10-5
Mr. Kee Wong
Mr. Kee Wong
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Abstract
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Introduction:

In line with the GIRFT report, we began to adopt the recommendation to provide definitive treatment for suitable patients with ureteric stones, rather than interim ureteric stent. We assessed the feasibility and outcome of performing primary ureteroscopy in emergency theatre.

Patients and Methods:

From June till November 2018 (6 months), all patients with CT confirmed ureteric stones requiring intervention in emergency theatre were included. Data regarding demographic, stone, various outcomes including timing of procedure, length of hospital stay, complications and re-admission were prospectively recorded.

Results:

A total of 37 patients (11 female: 26 male; mean age 50, range 17-87) were included. 70%(26/37) had primary ureteroscopy. Out of 11/37 patients who had stent only, three had access failure, five had ureteroscopy abandoned due to initial pus drainage and three had pre-operative decision to stent only due to associated infection.

For primary ureteroscopy, mean stone size was 6.5mm(2-19). One patient had bilateral ureteric stones and three ipsilateral ureters had more than 1 stone. The ratios for stone location upper:mid:distal were 7:2:18 respectively(27 ureters). Majority of cases(73%) were performed within the same proposed day of listing on emergency theatre. Mean operative time was 41 minutes(13-121). Median length of stay post-operation was 1 day(0-12).

For complications, 2 patients had prolonged admission (one post-operative pain, another with non-urological issue) and 1 with ureteric perforation. 8%(2/26) had non-elective re-admission within 30 days. 12%(3/26) required further ancillary procedure.

Conclusion:

In our experience, primary ureteroscopy in emergency theatre is safe, practical and achievable in appropriated selected patients.
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