Trainee-Associated Factors and Proficiency at Percutaneous Nephrolithotomy
Percutaneous nephrolithotomy (PNL) is a complicated procedure for urology trainees. This study was designed to investigate the effect of trainees’ ages and previous experience, as well as the number of operated cases, on proficiency at PNL by using patient outcomes. A cross sectional observational study was designed during a five-year period. Trainees in PNL fellowship programs were included. At the end of the program, the trainees’ performance in PNL was assessed regarding five competencies and scored 1-5. If the overall score was 4 or above, the trainee was considered as proficient. The trainees’ age at the beginning of the program and the years passed from their residency graduation were asked and recorded. Also, the number of PNL cases operated by each trainee was obtained via their logbooks. The age, years passed from graduation, and number of operated cases were compared between two groups of proficient and non-proficient trainees. Univariate and multivariate binary logistic regression analysis was applied to estimate the effect of aforementioned variables on the occurrence of the proficiency. Forty-two trainees were included in the study. The mean and standard deviation for the overall score were 3.40 (out of 5) and 0.67, respectively. Eleven trainees (26.2%) recognized as proficient in performing PNL. Univariate regression analysis indicated that each of three variables (age, years passed from graduation and number of operated cases) had statistically significant effect on proficiency. However, the multivariate regression analysis revealed that just the number of cases had significant effect on achieving proficiency. Although it might be assumed that trainees’ age negatively correlates with their scores, in fact, it is their amount of practice that makes a difference. A certain number of cases is required to be operated by a trainee in order to reach the desired competency in PNL.
Safarinejad MR. Adult urolithiasis in a population-based study in Iran: prevalence, incidence, and associated risk factors. Urol Res 2007;35:73-82.
Aghamir SM, Salavati A, Aloosh M, Farahmand H,Meysamie A, Pourmand G. Feasibility of totally tubeless percutaneous nephrolithotomy under the age of 14 years:a randomized clinical trial. J Endourol Soc 2012;26:621-4.
Ko R, Soucy F, Denstedt JD, Razvi H. Percutaneous nephrolithotomy made easier: a practical guide, tips and tricks. BJU Int 2008;101:535-9.
de la Rosette JJ, Laguna MP, Rassweiler JJ, Conort P.Training in percutaneous nephrolithotomy--a criticalreview. Eur Urol 2008;54:994-1001.
Mishra S, Jagtap J, Sabnis RB, Desai MR. Training inpercutaneous nephrolithotomy. Curr Opin Urol2013;23:147-51.
Kallidonis P, Kyriazis I, Vasilas M, Panagopoulos V,Georgiopoulos I, Ozsoy M, et al. Modular training forpercutaneous nephrolithotripsy: The safe way to go. ArabJ Urol 2015;13:270-6.
Allen D, O'Brien T, Tiptaft R, Glass J. Defining thelearning curve for percutaneous nephrolithotomy. JEndourol Soc 2005;19:279-82.
Tanriverdi O, Boylu U, Kendirci M, Kadihasanoglu M,Horasanli K, Miroglu C. The learning curve in thetraining of percutaneous nephrolithotomy. Eur Urol2007;52:206-12.
Ziaee SA, Sichani MM, Kashi AH, Samzadeh M.Evaluation of the learning curve for percutaneousnephrolithotomy. Urol J 2010;7:226-31.
Song Y, Ma Y, Song Y, Fei X. Evaluating the LearningCurve for Percutaneous Nephrolithotomy under TotalUltrasound Guidance. PloS One 2015;10:e0132986.
Garg A, Yadav SS, Tomar V, Priyadarshi S, Giri V, VyasN, et al. Prospective Evaluation of Learning Curve ofUrology Residents for Percutaneous Nephrolithotomy.Urol Pract 2016;3:230-5.
Waljee JF, Greenfield LJ, Dimick JB, Birkmeyer JD.Surgeon age and operative mortality in the United States.Ann Surg 2006;244:353-62.
Ho JD, Kuo NW, Tsai CY, Liou SW, Lin HC. Surgeonage and operative outcomes for primary rhegmatogenousretinal detachment: a 3-year nationwide population-basedstudy. Eye 2010;24:290-6.
Chai CY, Chen CH, Lin HW, Lin HC. Association ofincreasing surgeon age with decreasing in-hospitalmortality after coronary artery bypass graft surgery.World J Surg 2010;34:3-9.
Waljee JF, Zhong L, Shauver MJ, Chung KC. Theinfluence of surgeon age on distal radius fracturetreatment in the United States: a population-based study. JHand Surg 2014;39:844-51.
Ng CF. Training in percutaneous nephrolithotomy: Thelearning curve and options. Arab J Urol 2014;12:54-7.
|Issue||Vol 55, No 7 (2017)|
|Percutaneous nephrolithotomy Proficiency Education|
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