Our Summary
This research paper investigates the use of ureteral stents during surgeries for diverticulitis, a digestive condition affecting the colon. Some medical professionals believe that these stents help to prevent and more easily identify injuries to the ureter (the duct that carries urine from the kidney to the bladder), while others argue that the additional time, cost, and risks of placing these stents outweigh the potential benefits.
The study used data from patients who had undergone specific types of colon surgery for diverticulitis between 2000 and 2013. It found that the use of these stents increased during this period, particularly with laparoscopic (minimally invasive) procedures. Furthermore, stent use was more common in the Northeast of the US and in scheduled, rather than emergency, surgeries.
However, using a stent was also linked to longer hospital stays and higher costs. Despite the increasing use of these stents, there is no clear agreement on their overall benefit. As such, the authors of the study suggest further research is needed to truly understand the risks and benefits of ureteral stents, and to decide if their increased use is justified.
FAQs
- What is the purpose of using ureteral stents during surgeries for diverticulitis?
- Did the study find any downsides to using ureteral stents in diverticulitis surgeries?
- Is there a consensus in the medical community about the overall benefit of using ureteral stents in this type of surgery?
Doctor’s Tip
A doctor may advise a patient undergoing diverticulitis surgery to discuss with their healthcare team the potential use of ureteral stents and weigh the risks and benefits. It is important for the patient to understand that while stents may help prevent and identify ureteral injuries, they can also lead to longer hospital stays and increased costs. Ultimately, the decision to use a stent should be based on individual circumstances and the patient’s overall health. It is important to have a thorough discussion with the healthcare team to make an informed decision about the use of ureteral stents during diverticulitis surgery.
Suitable For
Patients who are typically recommended diverticulitis surgery are those who have severe or recurring symptoms of diverticulitis that do not respond to conservative treatment options such as antibiotics or dietary changes. These patients may experience symptoms such as severe abdominal pain, fever, nausea, and changes in bowel habits. In some cases, diverticulitis can lead to complications such as abscesses, perforations, or fistulas, which may require surgical intervention.
Surgery for diverticulitis may also be recommended for patients who have complications such as bowel obstruction, bleeding, or recurrent infections. Patients who have a history of multiple episodes of acute diverticulitis or who have a high risk of developing complications may also be candidates for surgery.
Overall, the decision to recommend diverticulitis surgery is based on the individual patient’s symptoms, medical history, and the severity of their condition. It is important for patients to discuss the risks and benefits of surgery with their healthcare provider in order to make an informed decision about their treatment options.
Timeline
In the timeline of a patient with diverticulitis before surgery, they may experience symptoms such as abdominal pain, bloating, changes in bowel habits, and fever. They may undergo diagnostic tests such as a colonoscopy, CT scan, or blood tests to confirm the diagnosis of diverticulitis.
After a decision is made to proceed with surgery for diverticulitis, the patient will undergo preoperative preparations such as bowel preparation, fasting, and possibly antibiotics to reduce the risk of infection during surgery. The surgery itself may involve removing the affected part of the colon, and in some cases, a temporary or permanent colostomy may be necessary.
After surgery, the patient will typically stay in the hospital for a few days for monitoring and recovery. They will be given pain medication, antibiotics, and instructions on how to care for their incision site. They may also be put on a liquid diet initially before gradually transitioning to solid foods.
In the weeks and months following surgery, the patient will attend follow-up appointments with their surgeon to monitor their recovery and ensure that there are no complications. They may also be referred to a dietitian to help with dietary changes that may be necessary to prevent future flare-ups of diverticulitis. Overall, the goal of surgery for diverticulitis is to alleviate symptoms, prevent complications, and improve the patient’s quality of life.
What to Ask Your Doctor
Some questions a patient should ask their doctor about diverticulitis surgery include:
- What are the potential risks and benefits of using ureteral stents during my surgery?
- How will the use of ureteral stents affect my recovery time and overall outcome?
- Are there alternative strategies or techniques that can be used instead of ureteral stents?
- How common is it for complications to arise from the placement of ureteral stents during diverticulitis surgery?
- How will the use of ureteral stents impact the cost of my surgery and post-operative care?
- What specific factors will you consider when deciding whether or not to use ureteral stents in my case?
- Can you provide me with more information or resources to help me understand the potential benefits and risks of using ureteral stents during diverticulitis surgery?
- Are there any specific guidelines or recommendations that support the use of ureteral stents in diverticulitis surgery?
- How will the placement of ureteral stents be monitored and managed during and after my surgery?
- What is your personal experience and expertise with using ureteral stents in diverticulitis surgery, and do you have any particular concerns or considerations in my case?
Reference
Authors: Chiu AS, Jean RA, Gorecka J, Davis KA, Pei KY. Journal: J Surg Res. 2018 Feb;222:203-211.e3. doi: 10.1016/j.jss.2017.09.050. Epub 2017 Oct 31. PMID: 29100586