Aarhus University Hospital SKEJBY, DENMARK Aarhus University Hospital SKEJBY, DENMARK Outpatient endoscopic treatment of ureteric stones - 5 years’ experience.

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Presentation transcript:

Aarhus University Hospital SKEJBY, DENMARK Aarhus University Hospital SKEJBY, DENMARK Outpatient endoscopic treatment of ureteric stones - 5 years’ experience in a self-contained outpatient surgery unit J Kirkegaard AM Ryhammer UT Larsen M Borre Dep. of Urology Dep. of Anaesthesiology and Intensive Care University Hospital of Aarhus, Denmark

Aarhus University Hospital SKEJBY, DENMARK Aarhus University Hospital SKEJBY, DENMARK Why day surgery? Results from the literature Good for the patients Good for the doctors Good for the tax payers Day surgery, development & Practice,, 2006, At our department Long waiting lists Budget cuts

Aarhus University Hospital SKEJBY, DENMARK Aarhus University Hospital SKEJBY, DENMARK physically separated own staff own management run by two dedicated anaesthesiologists

Aarhus University Hospital SKEJBY, DENMARK Aarhus University Hospital SKEJBY, DENMARK Day Surgery Unit Arrival and departure point

Aarhus University Hospital SKEJBY, DENMARK Aarhus University Hospital SKEJBY, DENMARK Day Surgery Unit Recovery room

Aarhus University Hospital SKEJBY, DENMARK Aarhus University Hospital SKEJBY, DENMARK Results - patients 178 patients underwent 186 procedures including only endoscopic removal of ureteric stones

Aarhus University Hospital SKEJBY, DENMARK Aarhus University Hospital SKEJBY, DENMARK Results - stones Stone free rate: 85% Median stone size 7 (5 – 9)* mm 157 of the 178 patients had 1 stone Proximal ureter: 20% Medial ureter: 20% Distal ureter: 60% *Interquartile range

Aarhus University Hospital SKEJBY, DENMARK Aarhus University Hospital SKEJBY, DENMARK Results Median operating time 53 (35 – 72)* minutes Median length of stay (arrival to departure) 4:06 hours (range 3:02 – 5:00)** *Interquartile range **Subset analysis

Aarhus University Hospital SKEJBY, DENMARK Aarhus University Hospital SKEJBY, DENMARK Results - surgeon’s charge Urologist specialist Non-specialistP-value No. of procedures140 (75%)46 (25%) Stone free rate84%87%0.8 Operating time50 minutes59.5 minutes0.06 complications15%26%0.12

Aarhus University Hospital SKEJBY, DENMARK Aarhus University Hospital SKEJBY, DENMARK Results - complications

Aarhus University Hospital SKEJBY, DENMARK Aarhus University Hospital SKEJBY, DENMARK Conclusion In a day surgery setting our results on URSL regarding Stone free rate Operating times Complications Are satisfactory and comparable to those reported in other studies (both in-patient and out-patient) Length of stay in the day surgery unit is very short Can be done without sacrificing educational goals