Percutaneous nephrolithotomy access by urologist or interventional radiologist: practice and outcomes in the UK.
BJU Int
; 119(6): 913-918, 2017 06.
Article
em En
| MEDLINE
| ID: mdl-28220589
ABSTRACT
OBJECTIVE:
To compare outcomes of urologist vs interventional radiologist (IR) access during percutaneous nephrolithotomy (PCNL) in the contemporary UK setting. PATIENTS ANDMETHODS:
Data submitted to the British Association of Urological Surgeons PCNL data registry between 2009 and 2015 were analysed according to whether access was obtained by a urologist or an IR. We compared access success, number and type of tracts, and perceived and actual difficulty of access. Postoperative outcomes, including stone-free rates, lengths of hospital stay and complications, including transfusion rates, were also compared.RESULTS:
Overall, percutaneous renal access was undertaken by an IR in 3453 of 5211 procedures (66.3%); this rate appeared stable over the entire study period for all categories of stone complexity and in cases where there was predicted or actual difficulty with access. Only 1% of procedures were abandoned because of failed access and this rate was identical in each group. IRs performed more multiple tract access procedures than urologists (6.8 vs 5.1%; P = 0.02), but had similar rates of supracostal punctures (8.2 vs 9.2%; P = 0.23). IRs used ultrasonograhpy more commonly than urologists to guide access (56.6% vs 21.7%, P < 0.001). There were no significant differences in complication rates, lengths of hospital stay or stone-free rates.CONCLUSIONS:
Our findings suggest that favourable PCNL outcomes may be expected where access is obtained by either a urologist or an IR, assuming that they have received the appropriate training and that they are skilled and proficient in the procedure.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Urologia
/
Nefrostomia Percutânea
/
Cálculos Renais
/
Radiologia Intervencionista
Tipo de estudo:
Prognostic_studies
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
BJU Int
Assunto da revista:
UROLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Reino Unido
País de publicação:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM