背景:本文试图对仰卧位经皮肾镜取石术(PCNL)技术的学习目标和重要性进行全面综述。
方法:我们回顾性回顾了2018年1月至2024年1月的仰卧PCNL病例。我们将小组分为3组:2至3岁的居民(第1组),4至5岁的居民(第2组),和器官学专家(第3组)。这位2-3年的居民首次开始执行PCNL,而4-5年的住院医师首次开始进行仰卧PCNL,而此前曾进行易感PCNL。
结果:访问,透视,第1组手术时间较高,第2组手术时间较短,第3组手术时间最短(p<0.001)。发现术后住院时间和额外治疗的需要较短(p<0.001),从第1组到第3组,无结石率(SFR)增加(p<0.001)。在第1组中观察到最高的并发症发生率(p=0.002)。第1组患者的SFR率随着病例数的增加而增加。在SFR方面,成功在46-60例之后是稳定的。在第2组中,SFR率在31-45后稳定。
方法:第1组并发症最多,第3组并发症最少。
结论:在2-3岁的居民中,访问时间和透视时间随着经验的减少而减少。在4-5年的居民中,由于他们在易发PCNL方面的专业知识,手术时间和透视时间随着病例数的增加而减少。在2-3年居民46-60例和4-5年居民31-45例后,SFR较高。
BACKGROUND: This article attempts to provide a comprehensive review of the learning objectives and importance of the supine percutaneous nephrolithotomy (PCNL) technique.
METHODS: We retrospectively reviewed the cases of Supine PCNL between January 2018 and January 2024. We divided the groups into 3: residents between 2 and 3 years (Group 1), residents between 4 and 5 years (Group 2), and endourologist (Group 3). The 2-3-year resident started to perform PCNL for the first time, while the 4-5-year resident started to perform Supine PCNL for the first time while previously performing prone PCNL.
RESULTS: Access, fluoroscopy, and operation time were higher in Group 1, shorter in Group 2, and shortest in Group 3 (p < 0.001). Postoperative length of stay and the need for additional treatment were found to be shorter (p < 0.001), and the stone-free rate (SFR) increased (p < 0.001) from Group 1 to Group 3. The highest complication rates were observed in Group 1 (p = 0.002). SFR rate increased as the number of cases increased in Group 1 patients. Success was stable after 46-60 cases in terms of SFR. In Group 2, the SFR rate was stable after 31-45.
METHODS: The most complications were observed in Group 1 and the least in Group 3.
CONCLUSIONS: In 2-3-year residents, access time and fluoroscopy time decrease with experience. In 4-5-year residents, due to their expertise in prone PCNL, the operation time and fluoroscopy time decrease with the number of cases performed. SFR is higher after 46-60 cases for 2-3-year residents and 31-45 cases for 4-5-year residents.