Objective: In our clinic, 200 percutaneous nephrolithotomy (PNL) cases were perfomed by an experienced surgeon who was completed his training and learning curve in another centre and an unexperienced surgeon who was starting PNL under an experienced surgeon’s supervisi-on.
Our aim is to examine these 200 cases in two periods, and to compare the preoperative, opera-tive and postoperative patient’s data and success ratios for both of surgeons within this period.
Material and Methods: In our clinic; the 200 PNL operations, which were performed bet-ween August 2010 and July 2012, were examined and seperated into two groups as performed by experienced or inexperienced surgeons. All facts’ preoperative and demogrophic datas were evaluated. Besides; the facts were compared in case of the size of the stone, stone localization, the duration of the operation, fluoroscopy, pro-cess of nephroscopy taken, the rates of preopera-tive hemoglobin and hematocrit, postoperative hemoglobin and hematocrit, the rates of comp-lication, transfusion rates and being stone-free.
Findings: The experienced surgeon’s ope-ration time was 2.21 hours and inexperienced surgeon’s was 2.76 hours. Again; scopy periods/durations were calculated as 2.81 minutes for the experienced and 4.05 minutes for inexperien-ced surgeon. The duration of removal of neph-rostomy tube. W ere calculated as 2.75 days for the experienced and 3.84 days for the inexperienced surgeon. In the experienced group, only 4 transfusions were made, yet in inex-perienced group, this number reached 14. For the first period; a meaningful difference was determined statistically between both the surgeons in the duration of operation, scopies and removing nefrostomy and transfusion rates (p<0,05). But there were no statis-tically significant differences in terms of the complication rates and the presence of residual stones.
In the second period, statistically significant difference was not observed in terms of operation time, fluoroscopy time, transfusion rate, postoperative hematocrit and hemoglobin values, complicati-on rates and the presence of residual stones.
Conclusion: At experienced surgeons clinic, inexperienced surgeon can learn PNL fast and safely. We have decided that 45 cases is enough to learn the PNL operation.
Keywords: percutaneous nephrolithotomy, kidney stone, complication
Abstract
Objective: In our clinic, 200 percutaneous nephrolithotomy (PNL) cases were perfomed by an experienced surgeon who was completed his training and learning curve in another centre and an unexperienced surgeon who was starting PNL under an experienced surgeon’s supervisi-on.
Our aim is to examine these 200 cases in two periods, and to compare the preoperative, opera-tive and postoperative patient’s data and success ratios for both of surgeons within this period.
Material and Methods: In our clinic; the 200 PNL operations, which were performed bet-ween August 2010 and July 2012, were examined and seperated into two groups as performed by experienced or inexperienced surgeons. All facts’ preoperative and demogrophic datas were evaluated. Besides; the facts were compared in case of the size of the stone, stone localization, the duration of the operation, fluoroscopy, pro-cess of nephroscopy taken, the rates of preopera-tive hemoglobin and hematocrit, postoperative hemoglobin and hematocrit, the rates of comp-lication, transfusion rates and being stone-free.
Findings: The experienced surgeon’s ope-ration time was 2.21 hours and inexperienced surgeon’s was 2.76 hours. Again; scopy periods/durations were calculated as 2.81 minutes for the experienced and 4.05 minutes for inexperien-ced surgeon. The duration of removal of neph-rostomy tube. W ere calculated as 2.75 days for the experienced and 3.84 days for the inexperienced surgeon. In the experienced group, only 4 transfusions were made, yet in inex-perienced group, this number reached 14. For the first period; a meaningful difference was determined statistically between both the surgeons in the duration of operation, scopies and removing nefrostomy and transfusion rates (p<0,05). But there were no statis-tically significant differences in terms of the complication rates and the presence of residual stones.
In the second period, statistically significant difference was not observed in terms of operation time, fluoroscopy time, transfusion rate, postoperative hematocrit and hemoglobin values, complicati-on rates and the presence of residual stones.
Conclusion: At experienced surgeons clinic, inexperienced surgeon can learn PNL fast and safely. We have decided that 45 cases is enough to learn the PNL operation.
Keywords: percutaneous nephrolithotomy, kidney stone, complication