Weimin Yu1, Ting Rao1, Xing Li1, Yuan Ruan1, Run Yuan1, Chenglong Li1, Haoyong Li1, Fan Cheng2. 1. Department of Urology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China. 2. Department of Urology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China. 1025931346@qq.com.
Abstract
AIM: The aim of the current trial was to evaluate the learning curve of access creation through solo ultrasonography (US)-guided percutaneous nephrolithotomy (PCNL), and clarify the technical details of the procedure. MATERIALS AND METHODS: We evaluated the first 240 solo US-guided PCNLs performed by one surgeon at our institution. The data including the puncture procedure, access characteristics, access-related complications and stone-free rates were assessed in four sequential groups. RESULTS: The puncture duration and number of times decreased from a mean of 4.4 min and 2.1 times for the first 60 patients to 1.3 min and 1.2 times for the last 60 patients. There was a significant decrease from 3.7 min and 1.8 times for the 61th-120th patients to 1.5 min and 1.3 times for the 121th-180th patients. All of the access-related severe bleeding appeared in the first 120 patients, while perforations only occurred in the first 60 patients. The stone-free rates were 68.3, 83.3, 90.0, and 93.3% for the four sequential groups. CONCLUSION: The increase in experience lead to an improvement in the puncture duration and times, which accompany with better stone-free rates and lower complications. We propose that 60 operations are sufficient to gain competency, and a cutoff point of 120 operations will allow the surgeon to achieve excellence in the solo US-guided PCNL.
AIM: The aim of the current trial was to evaluate the learning curve of access creation through solo ultrasonography (US)-guided percutaneous nephrolithotomy (PCNL), and clarify the technical details of the procedure. MATERIALS AND METHODS: We evaluated the first 240 solo US-guided PCNLs performed by one surgeon at our institution. The data including the puncture procedure, access characteristics, access-related complications and stone-free rates were assessed in four sequential groups. RESULTS: The puncture duration and number of times decreased from a mean of 4.4 min and 2.1 times for the first 60 patients to 1.3 min and 1.2 times for the last 60 patients. There was a significant decrease from 3.7 min and 1.8 times for the 61th-120th patients to 1.5 min and 1.3 times for the 121th-180th patients. All of the access-related severe bleeding appeared in the first 120 patients, while perforations only occurred in the first 60 patients. The stone-free rates were 68.3, 83.3, 90.0, and 93.3% for the four sequential groups. CONCLUSION: The increase in experience lead to an improvement in the puncture duration and times, which accompany with better stone-free rates and lower complications. We propose that 60 operations are sufficient to gain competency, and a cutoff point of 120 operations will allow the surgeon to achieve excellence in the solo US-guided PCNL.
Authors: Abbas Basiri; Amir M Ziaee; Hamid R Kianian; Sadrallah Mehrabi; Hormoz Karami; Seyed M Hosseini Moghaddam Journal: J Endourol Date: 2008-02 Impact factor: 2.942
Authors: B O Manzo; J E Torres; J D Cabrera; E Lozada; E Emiliani; F Sepulveda; C Morales; I Morales; H M Sanchez Journal: World J Urol Date: 2021-03-23 Impact factor: 4.226