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World J Urol ; 35(12): 1933-1938, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28695419

RESUMEN

OBJECTIVE: We report on the comparison of clinical results of the early phase of implementation of minimally invasive PNL (MIP) in a mentor-based approach with the later on clinical routine in a tertiary centre. PATIENTS AND METHODS: From January 2010 until January 2015 MIP was performed in 190 patients. Stone and patient characteristics were recorded in prospective manner. Perioperative complications were recorded within the Clavien-Classification. The first 120 consecutive patients undergoing MIP were evaluated and divided into three groups of 40 patients each. Mentor-based introduction of MIP was done within the first 40 patients (group A). Further patients were treated on routine clinical practice basis (group B and C). Treatment outcome was compared within the three groups. RESULTS: The groups did not significantly differ with regard to patient characteristics, operation time and decline in haemoglobin. In the mentor-based series mean stone size was 21.7 ± 12.6 vs. 15.6 ± 7.9 and 16.1 ± 8.4 mm in group B and C (p = 0.033). Primary stone-free rates were 65, 87.5 and 87.5% for the three groups (p = 0.015). Stone-free rate was higher in smaller and simple stones. Overall, complication rate was 41.7% including 36.7% Clavien grade I and II complications. CONCLUSIONS: MIP can be implemented safe and effectively with mentor-based approach. MIP has a high safety profile, which allows high safety and efficacy of MIP at the time of implementation.


Asunto(s)
Tutoría/métodos , Procedimientos Quirúrgicos Mínimamente Invasivos , Nefrolitiasis/cirugía , Nefrolitotomía Percutánea , Complicaciones Posoperatorias , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos/efectos adversos , Procedimientos Quirúrgicos Mínimamente Invasivos/educación , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Nefrolitiasis/epidemiología , Nefrolitotomía Percutánea/efectos adversos , Nefrolitotomía Percutánea/educación , Nefrolitotomía Percutánea/métodos , Tempo Operativo , Evaluación de Procesos y Resultados en Atención de Salud , Manejo de Atención al Paciente/organización & administración , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología
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