Is pre-operative imaging essential prior to ureteric stone surgery?
作者信息
Youssef F R, Wilkinson B A, Hastie K J, Hall J
机构信息
Sheffield Teaching Hospitals NHS Foundation Trust, UK.
出版信息
Ann R Coll Surg Engl. 2012 Sep;94(6):428-31. doi: 10.1308/003588412X13373405385458.
INTRODUCTION
The aim of this study was to identify patients not requiring ureteric stone surgery based on pre-operative imaging (within 24 hours) prior to embarking on semirigid ureteroscopy (R-URS) for urolithiasis.
METHODS
The imaging of all consecutive patients on whom R-URS for urolithiasis was performed over a 12-month period was reviewed. All patients had undergone a plain x-ray of the kidney, ureters and bladder (KUB), abdominal non-contrast computed tomography (NCCT-KUB) or both on the day of surgery.
RESULTS
A total of 96 patients were identified for the study. Stone sizes ranged from 3 mm to 20 mm. Thirteen patients (14%) were cancelled as no stone(s) were identified on pre-operative imaging. Of the patients cancelled, 8 (62%) required NCCT-KUB to confirm spontaneous stone passage.
CONCLUSIONS
One in seven patients were stone free on the day of surgery. This negates the need for unnecessary anaesthetic and instrumentation of the urinary tract, with the associated morbidity. Up-to-date imaging prior to embarking on elective ureteric stone surgery is highly recommended.
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