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Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
Published on: August 6, 2019
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Optimising pre-operative imaging-surgery intervals for stones.
Ijeoma Chibuzo1, Aleksandar Vucicevic1, Abisola Oliyide1
1Department of Urology Stepping Hill Hospital Stockport UK.
BJUI Compass
|August 28, 2023
Summary
Updating reference imaging before kidney stone surgery is crucial. For ureteric stones, update imaging within 9 weeks; for renal stones, update within 19 weeks to avoid negative surgical outcomes.
Area of Science:
- Urology
- Medical Imaging
- Surgical Outcomes
Background:
- NICE guidelines recommend timely intervention for acute ureteric colic.
- NHS face challenges including long waiting times and limited resources, impacting timely stone treatment.
- Outdated reference images (RIs) pose a risk for upper tract stone surgeries due to potential stone burden changes.
Purpose of the Study:
- To evaluate the impact of imaging-surgery intervals (ISIs) on upper tract stone surgery outcomes.
- To determine a cut-off ISI that necessitates updated reference imaging.
- To improve surgical efficiency and patient safety by optimizing imaging protocols.
Main Methods:
- Retrospective analysis of 427 upper tract stone surgeries.
- Categorization of stones into renal/pelvic (RENAL) and ureteric.
- Use of receiver operating curves (ROCs) to identify ISI cut-offs predictive of intra-operative disparity (IOD).
Main Results:
- No stones were found intraoperatively in 12.1% of patients.
- Longer ISIs were significantly associated with IODs, particularly for ureteric stones (p=0.011).
- Recommended ISI cut-offs for updated imaging: 9 weeks for ureteric stones and 19 weeks for renal stones.
Conclusions:
- Reference imaging for ureteric stones should be updated if over 9 weeks old.
- Reference imaging for renal stones should be updated if over 19 weeks old.
- Adhering to these updated imaging intervals can enhance surgical accuracy and patient safety.
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