The learning curve in the training of percutaneous nephrolithotomy.
نویسندگان
چکیده
OBJECTIVES To investigate the learning curve in the training of percutaneous nephrolithotomy (PCNL). METHODS A total of 104 PCNL cases were included in this evaluation to define the learning curve of a surgeon with no previous experience at performing solo PCNL. Two parameters of expertise were reviewed, namely the operation and fluoroscopic screening times. The operation time was calculated as the beginning of access with the needle until the nephrostomy tube was placed and secured. PCNL procedures were analyzed in seven sets of 15 cases regarding the operation and fluoroscopy times, stone size, stone clearance rate, blood transfusion rate, and estimated blood loss. RESULTS The mean operation time was 2.4 h for the first 15 patients. It decreased to a mean of 1.5 h for cases 46 through 60. No further decrease in the operation time was observed after case 60. The fluoroscopic screening time was a peak of 17.5 min in the first 15 cases, whereas it dropped to a mean of 8.9 min for cases 46 through 60. The decline in the mean fluoroscopy screening time continued in cases 61 to 104, but the decline was not significant. There was no significant difference in stone size, stone clearance rate, blood transfusion rate, and estimated blood loss among each set of cases. CONCLUSIONS This study suggests that the surgical competence in PCNL can be reached after 60 cases. PCNL and fluoroscopy times drop to a steady-state level after performing 60 procedures.
منابع مشابه
Training in percutaneous nephrolithotomy: The learning curve and options
OBJECTIVE To review the current approach to training and the learning curve for percutaneous nephrolithotomy (PCNL), and to formulate a recommendation for structured PCNL training for the urologist in-training. METHODS Publications related to PCNL training, simulator training, surgical training and working-hour restrictions on surgical training were reviewed. RESULTS The key components for ...
متن کاملSafety and efficacy of the Percutaneous Nephrolithotomy in Pediatrics; A 10-year single-center experience in Iran
Background: The aim of this study was to describe the one-decade experience in Percutaneous Nephrolithotomy surgery in children with kidney stones in Tehran, Iran. Methods: All patients (less than 18 years old) undergoing Percutaneous Nephrolithotomy at our referral medical center, were reviewed in this cross-sectional study. All the demographics, surgical data and post-operative information...
متن کاملEffects of Tranexamic Acid on Bleeding and Hemoglobin Levels in Patients Undergoing Percutaneous Nephrolithotomy: Letter to Editor
متن کامل
Laparoscopic Assisted ultrasound guided Percutaneous Nephrolithotomy (PCNL) in Ectopic Pelvic Kidney
We report a patient with pain, abdominal palpable mass and a history of previous open renal stone surgery. Imaging studies showed a right pelvic kidney with multiple calyceal stones. We describe the successful management through laparoscopic assisted percutaneous nephrolithotomy with ultrasonography (PCNL) in ectopic pelvic kidney, stressing that this method is a minimally invasive therapeutic...
متن کاملAnalgesic Efficacy of Nephrostomy Tract inFiltration of Bupivacaine and Ketamine after Tubeless Percutaneous Nephrolithotomy: A Prospective Randomized Trial
Objectives:The aim of the present study was to assess the analgesic efficacy of IV ketamine injection inaddition to nephrostomy tract infiltration of ketamine – bupivacaine on postoperative pain relief after tubeless percutaneous nephrolithotomy (PCNL). Patients and Methods: Patients (n = 100), with renal stone who were candidates for PCNL were randomized to five groups with 20 cases in each: G...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- European urology
دوره 52 1 شماره
صفحات -
تاریخ انتشار 2007