Guideline for Prevention Forgotten DJ Stent Removal in Buriram Hospital
Article Sidebar
Main Article Content
Abstract
Introduction: Ureteral stents placement is an important adjunct to many urological procedures. Nonetheless, potential risk of errors resulted in complications. Morbidities from these complications are subsequently medico-legal dilemma.
Objective: To compare the incident of forgotten Double J stent removal in urological patients before and after implementation guideline for prevention forgotten DJ stent removal at Buriram hospital.
Methods: Descriptive study was conducted in urosurgical in patients at Buriram hospital. All patients were underwent ureteral stents. We followed the guideline for prevention forgotten DJ stent removal by book of DJ stent. We compared patients data, DJ stent indications, duration of DJ stent insertion, an incident of forgotten DJ stent removal between before and after implementation guideline. Datas were demonstrated in mean and percentage.
Results: There were 87,85,72 and 81 patients in years 2004, 2005-2007, respectively. Patients in 2004 were treated before implemented guideline and in year 2005-2007 were treated after implemented guideline. Their mean ages were 49.05, 49.26, 49.12and 48.19 years, respectively. The indications of DJ stent insertion were prevention of postoperative complications, 65.10%, 58.80%, 56.90%, 71.80% in years 2004-2007, respectively. An incident of forgotten DJ stent removal before implementation guideline was 2.30%, no patient was forgotten DJ stent removal after implementation guideline, with significant different. (P<0.05)
Conclusion: Guideline for prevention DJ stent removal error in urosurgical patients was effective to decrease the incidence of error with statistically significant at p<0.05.
Article Details
References
2. บรรณกิจ โลจนาภิวัฒน์ ตำรานิ่วในระบบ ทางเดินปัสสาวะ การเกิดโรค การวินิจฉัย และการรักษา.อุปกรณ์ที่ใช้ร่วมกับการผ่าตัด รักษานิ่วโนระบบทางเดินปัสสาวะ. กรุงเทพมหานคร : บริษัท บียอนด์ เอ็นเทอร์ไพรซ์ จำกัด; 2548:357-73.
3. Pollard SG, MacFarlane R ; Symptoms arising from double-J ureteral stent, J Urol 1988;139:37-8.
4. Kemppainen E, Talja M, Riihela M, et al. A bioabsorbable ureteral stent. An experimental study. Urol Res 1993;21:235-8.
5. Dunn MD, Portis AJ, Khan SA, et al. Clinical effectiveness of a new stent design: Randomizied single blinded comparison of tall and double pigtail stents. J Endourol 200;14:195-202.
6. Tschada RK, Henkel TO, Junemann KP, et al. Spiral reinforced ureteral stent: An alternative for internal urinary diversion. J Endourol 1994;8;119-23.
7. Joshi HB, Chitale SV, Nagarajan M, Irving SO, Browning AJ, et al. A prospective randomizied single blind comparison of ureteral stent composed of firm and soft polymer. J Urol 2005;174:2303-6.
8. Schulze KA, Wettlaufer JN, Oldami G. Encrustation and stone formation : Complication of indwelling ureteral stents. Urology 1986;25:616-9
9. Aron M, Anari MS, et al. Forgotten ureteral stent causing renal failure : multimodal endourologic treatment. J Endourol 2006:20(6):423-8
10. Puhse G, Piechota H, et al. Multiorgan failure 17 years after initial stone therapy : forgotten ureteral stent in a horseshoe Kidney. Eur Urol 2007;52(6):1784-7
11. Rembrink K, Goepel M, Meyer- Schwickerath M. The forgotten double J stent- Case report of a multifractured ureter stent. Urol Int 1992;49:119-20.
12. Aegukkataji S. Epidemiology of stone diseases in north-eastern Thailand. In: Urolithiasis: Current status.! 7th ed. Acadeic Meeting of the Royal College of Surgeons of Thailand 2003:1-17.
13. Soontornpan S. Epidemiology of stone diseases in Chaing Mai University Hospital. In: Urolithiasis: Current status. 17th ed. Acadeic Meeting of the Royal College of Surgeons of Thailand 2003:18-23.
14. Tanthanuch M, Apiwatgaroon A, Pripatnanont C. Urinary tract calculi in Southern Thailand. J Med Assoc Thai 2005;88:80-5.
15. Thomas AZ,Casey RG,Grainger R, Me Dermott T, Flynn R, Thornhill JA. The forgotten ureteric JJ stent and its preventions prospective audit of the value of a ureteric stent logbook.Ir J Med Sci.2007;176(2):117-9
16. Lynch MF, Ghani KR, Frost I, Anson KM. Preventing the forgotten ureteral stent: implementation of a web-based stent registry with automatic recall application. Urology 2007;70(3):423-6
