{"id":6070,"date":"2020-07-02T16:24:50","date_gmt":"2020-07-02T15:24:50","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=6070"},"modified":"2021-06-30T15:48:59","modified_gmt":"2021-06-30T14:48:59","slug":"optimising-patients-with-long-term-spinal-cord-injury-for-nephrectomy-a-review-of-pre-peri-and-post-operative-factors-to-safeguard-outcomes-2020","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2020\/07\/02\/optimising-patients-with-long-term-spinal-cord-injury-for-nephrectomy-a-review-of-pre-peri-and-post-operative-factors-to-safeguard-outcomes-2020\/","title":{"rendered":"Optimising patients with long-term spinal cord injury for nephrectomy: A review of pre-, peri- and post-operative factors to safeguard outcomes (2021)"},"content":{"rendered":"<p><strong>Type of publication:<\/strong><br \/>\nJournal article<\/p>\n<p><strong>Author(s):<\/strong><br \/>\n*Donati-Bourne J.; *Mohamed W.G.E.; *Pillai P.; *O'Dair J.; Kasmani Z.; Bhatt R.I.<\/p>\n<p><strong>Citation:<\/strong><br \/>\nJournal of Clinical Urology; 2021, Volume: 14 issue: 2, page(s): 78-84<\/p>\n<p><strong>Abstract:<\/strong><br \/>\nObjectives: To review the potential challenges a urologist may encounter when embarking on simple\/partial\/radical nephrectomy in patients with long-term spinal cord injury and propose strategies to pre-empt and manage these.<br \/>\nMaterial(s) and Method(s): Comprehensive literature review via PubMed, MEDLINE and Google Scholar searching for relevant scientific articles published to date in English. Recommendations for strategies to safeguard surgical outcomes discussed with a panel of experienced upper-tract urologists.<br \/>\nResult(s): Pre-operative considerations: \u2013 urethral assessment via flexible cystoscopy due to higher incidence of urethral pathology in spinal cord injury; \u2013 assessing for chronic constipation and distended bowel; and \u2013 considering glomerular filtration rate assessment by radio-isotope techniques, such as 51chromium-EDTA Perioperative considerations: \u2013 adequate theatre staffing for safe patient transfer; and \u2013 planned choice of incision, due to higher incidence of previous abdominal surgery, stoma bags and\/or foreign body devices. Post-operative considerations: \u2013 ensuring attending medical staff are trained to recognise autonomic dysreflexia; \u2013 early remobilisation with physiotherapists experienced in treating spinal cord injury; and \u2013 attentive antibiotic stewardship due to higher risk of hospital-acquired or urinary infections<br \/>\nConclusion(s): Patients with long-term spinal cord injury pose significant potential challenges in the pre-, periand post-operative stages of nephrectomy. Familiarisation and optimisation of such factors is recommended to safeguard outcomes.<br \/>\nLevel of Evidence: Not applicable for this multicentre audit.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Type of publication: Journal article Author(s): *Donati-Bourne J.; *Mohamed W.G.E.; *Pillai P.; *O'Dair J.; Kasmani Z.; Bhatt R.I. Citation: Journal of Clinical Urology; 2021, Volume: 14 issue: 2, page(s): 78-84 Abstract: Objectives: To review the potential challenges a urologist may<span class=\"ellipsis\">&hellip;<\/span><\/p>\n<div class=\"read-more\"><a href=\"https:\/\/www.library.sath.nhs.uk\/research\/2020\/07\/02\/optimising-patients-with-long-term-spinal-cord-injury-for-nephrectomy-a-review-of-pre-peri-and-post-operative-factors-to-safeguard-outcomes-2020\/\">Read more <span class=\"screen-reader-text\">Optimising patients with long-term spinal cord injury for nephrectomy: A review of pre-, peri- and post-operative factors to safeguard outcomes (2021)<\/span><span class=\"meta-nav\"> &#8250;<\/span><\/a><\/div>\n<p><!-- end of .read-more --><\/p>\n","protected":false},"author":12,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[200],"tags":[979,778,751],"class_list":["post-6070","post","type-post","status-publish","format-standard","hentry","category-staff-publication","tag-979","tag-nephrectomy","tag-spinal-injuries"],"_links":{"self":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/6070","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/comments?post=6070"}],"version-history":[{"count":4,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/6070\/revisions"}],"predecessor-version":[{"id":6573,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/6070\/revisions\/6573"}],"wp:attachment":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/media?parent=6070"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/categories?post=6070"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/tags?post=6070"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}