One-stage tubeless antegrade ureteric stenting: a safe and cost-effective option?

Abstract:

INTRODUCTION:Antegrade insertion of ureteric stent has become an established mode of management of upper tract obstruction secondary to ureteric pathology. It is conventionally performed as a two-stage procedure for various reasons but, more recently, a one-stage approach has been adopted. PATIENTS AND METHODS:We discuss our experience of primary one-stage insertion of antegrade ureteric stent as a safe and cost-effective option for the management of these difficult cases in this retrospective observational case cohort study of patients referred to a radiology department for decompression of obstructed upper tracts. Data were retrieved from case notes and a radiology database for patients undergoing one-stage and two-stage antegrade stenting. It was followed by telephone survey of regional centres about the prevalent local practice for antegrade stenting. Outcome measures like hospital stay, procedural costs, requirement of analgesia/antimicrobials and complication rates were compared for the two approaches. RESULTS:a one-stage approach was found to be suitable in most cases with many advantages over the two-stage approach with comparable or better outcomes at lower costs. Some of the limitations of the study were retrospective data collection, more than one radiologist performing stenting procedures and non-availability of interventional radiologist falsely raising the incidence of two-stage procedures. CONCLUSIONS:In the absence of any clinical contra-indications and subject to availability of an interventional radiologist's support, one-stage antegrade stenting could easily be adopted as a routine approach for the management of benign or malignant ureteric obstruction.

journal_name

Ann R Coll Surg Engl

authors

Chitale S,Raja V,Hussain N,Saada J,Girling S,Irving S,Cockburn JF

doi

10.1308/003588410X12518836439128

subject

Has Abstract

pub_date

2010-04-01 00:00:00

pages

218-24

issue

3

eissn

0035-8843

issn

1478-7083

pii

ed6

journal_volume

92

pub_type

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