Department of Urology, the Chao Hu Hospital of Anhui Medical University, Hefei, China.
J Int Med Res. 2024 Mar;52(3):3000605241239026. doi: 10.1177/03000605241239026.
This study was performed to investigate the learning curve of ultrasound-guided percutaneous nephrolithotripsy (PCNL) for the treatment of complex renal calculi.
Seventy-two patients with complex renal stones who underwent ultrasound-guided PCNL by the same operator from November 2016 to September 2020 were retrospectively analyzed. The learning curve of PCNL for complex renal stones was analyzed using multifactorial cumulative sum (CUSUM) analysis and best-fit curves.
The CUSUM best-fit curve peaked at Case 36, which represented the minimum number of cumulative cases required to cross the learning curve for this surgical procedure. Accordingly, the learning curve was divided into a learning improvement period (36 cases) and a proficiency phase (36 cases). Compared with the learning improvement period, the proficiency phase was characterized by a shorter puncture time and operation time, a smaller drop in the hemoglobin level, and a lower postoperative complication rate.
The learning curve of PCNL for the treatment of complex renal calculi can be divided into a learning improvement period and a proficiency phase, and the minimum cumulative number of cases is 36.
本研究旨在探讨超声引导经皮肾镜碎石术（PCNL）治疗复杂性肾结石的学习曲线。
回顾性分析 2016 年 11 月至 2020 年 9 月由同一位术者行超声引导 PCNL 治疗的 72 例复杂性肾结石患者的临床资料。采用多因素累积和（CUSUM）分析和最佳拟合曲线对 PCNL 治疗复杂性肾结石的学习曲线进行分析。
CUSUM 最佳拟合曲线在第 36 例时达到峰值，这代表了该手术程序所需的累积病例数的最小值，以跨越学习曲线。因此，学习曲线分为学习提高期（36 例）和熟练期（36 例）。与学习提高期相比，熟练期的穿刺时间和手术时间更短，血红蛋白水平下降幅度更小，术后并发症发生率更低。
PCNL 治疗复杂性肾结石的学习曲线可分为学习提高期和熟练期，最小累积病例数为 36 例。
