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[Statistics on operations at Hara Genitourinary Hospital (1971-1991)]
1Hara Genitourinary Hospital.
Insights
The shift from open to closed urological surgeries, driven by new techniques like PNL, TUL, and ESWL, significantly increased minimally invasive procedures. This trend reversed the historical ratio of open to closed surgeries over two decades.
Area of Science:
- Urology
- Surgical Innovation
- Medical Technology
Context:
- Analysis of 9,170 operations from April 1971 to March 1991 in a private institution.
- Observed a significant increase in emergency operations compared to non-private hospitals.
- Documented a dramatic shift in surgical approach over a 20-year period.
Purpose:
- To analyze trends in inpatient operations, focusing on the transition from open to closed surgical procedures.
- To identify the impact of new endourological techniques on surgical practice.
- To evaluate the effectiveness and outcomes of specific procedures like ileal conduits.
Summary:
- A marked increase in closed endourological surgeries, including transurethral resections (TUR-P, TUR-Bt), percutaneous nephrolithotripsy (PNL), transurethral uretero-lithotripsy (TUL), and extracorporeal shock-wave lithotripsy (ESWL).
- Surgical procedures reversed from 71.0% open and 21.0% closed (1976-1980) to 8.2% open and 91.8% closed (1986-1991).
- PNL, TUL, and ESWL adoption led this change, with ESWL becoming dominant for urinary calculi by 1988, though combined approaches are now recognized.
Impact:
- Demonstrates the successful integration and impact of minimally invasive urological techniques.
- Highlights the evolution of surgical practice towards less invasive methods.
- Achieved good results with low complication rates and preserved renal function in procedures like ileal conduit creation.
Abstract:
The statistical analysis of the inpatients and operations in our department from April, 1971 to March, 1991 revealed a total of 9,170 operations. One of the biggest changes in treatment is a marked increase in closed surgery. This includes endourological surgeries; transurethral resections of prostate and bladder tumor (TUR-P, TUR-Bt), percutaneous nephrolithotripsy (PNL), transurethral uretero-lithotripsy (TUL) and extracorporeal shock-wave lithotripsy (ESWL). From 1976 to 1980 there were 721 open surgical procedures (71.0% of cases) and 295 closed procedures (21.0% of cases). This ratio has now been reversed completely. From 1986-1991, there were 342 open procedures (8.2% of cases) and 3808 closed procedures (91.8% of cases). The main reason for this change was the introduction of the new techniques PNL, TUL and ESWL. Other important observations include: The incidence of emergency operations was higher in this private institution than that seen in non-private hospitals. From 1986, there was an increase in the use of PNL and TUL for the management of urinary calculi, and from 1988, ESWL has overtaken PNL and TUL in the treatment of this condition. Recently the limitations of ESWL have been appreciated and the value of a combined approach to therapy, for selected cases, is being recognized. A total of 238 ileal or ileocecal conduits were created with good results. A low complication rate has been observed with preservation of renal function.