Surgery

Permanent URI for this collection

http://etd.aau.edu.et/handle/123456789/63

Browse

Browsing Surgery by Author "Abeselom Lemma"

Now showing 1 - 5 of 5
  • No Thumbnail Available
    Item
    Assessment Of Quality of Life of Patients on long term diversion (Percutaneous Nephrostomy Versus Ureteral Stent) Cross-Sectional Comparative Study
    (Addis Ababa University, 2025-12-01) Getu Andarge; Abeselom Lemma; Habtamu Aderaw
    Background: Obstructive uropathy from Ureteral Obstruction often requires urinary diversion When Definitive treatment Cannot Be Performed Promptly or is not planned at all when patient is a terminal. Two Common Long-Term Diversion options are Percutaneous nephrostomy (PCN) and Ureteric Stenting (Double-J Stent). Understanding how These Modalities affect Patients’ quality of life (Qol) and Clinical Profile is Essential for Informed, Patient-Centered Decision-Making. This Study Attempted to Fill That Gap by Evaluating Qol and Patient Reported Symptoms in adults Managed with PCN versus Ureteric Stents for Prolonged Ureteral obstruction. Methods: This Cross-Sectional Comparative Study Was Conducted at AAU TASH Hospital. Eligible Participants Are Adults Who Have Undergone Urinary Diversion for Ureteral Obstruction and Have Maintained Their Device (PCN Or Ureteric Stent) for at least 90 days. Data Collection Includes Combined In-Person Interviews and Medical Records Review. Qol Was Assessed Using Validated Instruments (Including Euroqol EQ-5D-5L) and a Tube-Related Symptom Questionnaire. Demographic and Clinical were Recorded. Descriptive Statistics Was Used to Summarize Groups, And Inferential Analyses (E.G. Bivariate and Multivariable Regression) Were Used to Identify Factors Associated with Qol Differences Between PCN And Stent Groups, Controlling for Potential Confounders. Ethical Approval was Obtained, and Oral Informed Consent Was Secured from All Participants The PCN Group Mainly included patients with advanced malignancy while the stent group includes patient with benign diseases and prophylactic before major complication. Analysis showed the stent group had a significantly higher overall health state (VAS Mean 59.7 Vs. 43.0, P <0.001) and better overall quality of life in most dominas of euro ol 5D 5L : the Bivariate analysis Demonstrated that mode of diversion, Malignancy Status, Duration And Purpose of Diversion Were Both Highly Significant Predictors of Quality of Life (QOL), and The Subsequent Multiple Regression Confirmed That These only Mode of Diversion And Purpose of Diversion Factors Were The Strongest Independent Variables, Together Explaining 22.2% of The QOL Variance, while Other Clinical Variables Were Not Significant Conclusion-for long-Term Diversion in This Cohort, The Double-J Ureteral Stent is Associated with A Superior quality of life Compared to the Percutaneous nephrostomy. The External Nature of the PCN Tube Imposes an Overwhelming, Independent Burden on Patient Self-Care and Mobility. Clinical Decision-Making Must Prioritize Internal Drainage Whenever Clinically Feasible.
  • No Thumbnail Available
    Item
    Correlation of Preoperative Urine Culture and Post Pcnl Stone Culture and their Association with Post Pcnlsirs
    (Addis Ababa University, 2024-10-09) Sadam Aliye; Abeselom Lemma
    Under ideal conditions PCNL has a stone clearance rate of over 90%. However, after PCNL, 10% to 35% of patients experience a systemic inflammatory reaction, and a small proportion progresses to sepsis
  • No Thumbnail Available
    Item
    Correlation of Preoperative Urine Culture and Post Pcnl Stone Culture and their Association with Post PCNLSIRS
    (Addis Ababa University, 2024-10-09) Sadam Aliye; Abeselom Lemma
    Under ideal conditions PCNL has a stone clearance rate of over 90%. However, after PCNL, 10% to 35% of patients experience a systemic inflammatory reaction, and a small proportion progresses to sepsis
  • No Thumbnail Available
    Item
    Outcome and Associated Factors of Two-Step Tract Dilation in a Complete Radiation Free Percutaneous Nephrolithotomy at Tikur Anbessa Specialized Hospital
    (Addis Ababa University, 2025-12-07) Endale Demeke; Mesay Mekonen; Abeselom Lemma
    Introduction: Percutaneous Nephrolithotomy is the Treatment of Choice for Complex Renal Stones. As Fluoroscopy Carries a Risk of Radiation Exposure, Ultrasound Guidance Has Emerged as an Alternative to Fluoroscopic Guidance. Objective: To Assess the Outcome, Safety and Efficacy of Ultrasound-Guided Percutaneous Nephrolithotomy (PCNL) Using A Two-Step Tract Dilation Method. Methods And Materials: A Cross-Sectional Study was done on 130 Cases That Underwent Ultrasound-Guided PCNL From January 1 to December 30, 2024. The Tract Was Dilated in a Two Step Fashion. In Step 1, after Puncturing The PCS, The Tract Was Dilated To 12 Fr. Then, A 9.5 Fr URS Was Introduced to Evaluate the Tract, Manipulate the Guide Wire, And Scan the Kidney. Finally, In Step 2, the Tract was Dilated to the Required Size. We Evaluated Patients' Demographic Features, Stone Complexity Using the S.T.O.N.E. Nephrolithometry Score, Complications Using the Clavien-Dindo Grading System, And Hospital Stay. On Postoperative day 1, A KUB Was Performed to Assess Stone-Free Status. Postoperatively, Patients were Followed up with Abdominal Ultrasound in the Outpatient Clinic. Results: of the 130 Cases, 84 (64.6%) were Male, And the Mean Age at Presentation Was 39.9 Years. About 35(26.9%) of Patients Had a Previous History of Open Renal Surgery. In 80% of Patients, The Stone Complexity Score Measured By S.T.O.N.E Score Was Between 6 and 8. In 86.9% of patients, only A Single Tract Was Used and the Mean total Duration of Surgery Was 100 Minutes. The Median Hospital Stay Was 2 days. Approximately 77.7% of patients had No Complications. The Mean Hemoglobin Drop Was 1.69 G/Dl, and there was no need for Transfusion. Prolonged urine leak was the most common complication (9.2%), and transient elevation of creatinine was seen at 35/77(45%). the Early Stone-Free Rate was 75.4%. Conclusion: Ultrasound-guided PCNL with two-step tract dilation is an effective and safe modality for performing PCNL and holds significant importance in resource-limited areas.
  • No Thumbnail Available
    Item
    Short and Long-Term Renal Function Trajectories and Associated Factors Following Ultrasound Guided Percutaneous Nephrolithotomy (Pcnl) Assessed by Estimated Glomerular Filtration Rate
    (Addis Ababa University, 2025-10-01) Samuel Fekadu; Abeselom Lemma; Fitsum Solomon
    Background: Percutaneous Nephrolithotomy (PCNL) is the Treatment of choice for large and Complex Renal Stones. Information Regarding Stone Clearance Outcomes are Well Established. But, Data on Short- and Long-Term Renal Function Changes After PCNL Procedure, Particularly in Low Resource Settings Is Limited. Objective: Assess Short- and Long-Term Renal Function Pattern After A PCNL Procedure and Identify Factors Associated with Change in Estimated Glomerular Filtration Rate (Egfr) Among Patients Managed at Tikur Anbessa Specialized Hospital Between September 1, 2023 and October 30, 2024 Methods: A Retrospective Cohort Study Was Conducted. A Prospectively Collected Data from a Previous Research Was Supplemented by Electronic Medical Record Review and Analysis Was Done. Patient’s Aged ≥15 Years Were Included. Renal Function Was Assessed Using Egfr (CKD-EPI 2021) At Baseline, 72 Hours, 3 Months, 6 Months, And 12 Months. Longitudinal Egfr Changes Were Analyzed Using Linear Mixed-Effects Models with Multiple Imputation for Missing Predictor Data. Results: 100 Patients Were Included in the Study with Mean Age 41.2 ± 12.8 Years And 67% Male Were Male. Mean Egfr Showed a Transient, Non-Significant Decline At 72 Hours Followed by Progressive Recovery, Exceeding Baseline Values At 12 Months By +5.68 Ml/Min/1.73 M² (P = 0.034) Which Was Not Significant When It Was Adjusted for Other Factors. Old Age and Presence of Comorbidities Were Independently Associated with Lower Egfr at Baseline but Has No Significant Impact on the Patter of Egfr During Follow-Up. Significant Effect of Hydronephrosis and CKD Was Seen on the Pattern of Egfr. Presence of Moderate to Severe Hydronephrosis Showed Poor Recovery Whereas Patients with CKD Stages 3 And 4 Showed Significant Relative Improvement over time. Operative factors were Nnt Independently Associated with Long-Term Renal Function. Conclusion: PCNL Results in a Transient Early Postoperative Decline Followed by Recovery and Long-Term Preservation or Improvement in Most Patients, having no Net Effect on Renal Function. Baseline Renal Function and Hydronephrosis Severity Primarily Determine Postoperative Renal Function Pattern.