Departmant of Urology, İzmir Tepecik Training and Research Hospital, İzmir, Türkiye.
Departmant of Urology, Bakırkoy Dr. Sadi Konuk Tepecik Training and Research Hospital, İstanbul, Türkiye.
Urolithiasis. 2024 Sep 9;52(1):129. doi: 10.1007/s00240-024-01624-w.
This article attempts to provide a comprehensive review of the learning objectives and importance of the supine percutaneous nephrolithotomy (PCNL) technique.
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.
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.
The most complications were observed in Group 1 and the least in Group 3.
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.
本文旨在全面回顾仰卧经皮肾镜取石术（PCNL）技术的学习目标和重要性。
我们回顾性分析了 2018 年 1 月至 2024 年 1 月期间仰卧 PCNL 的病例。我们将患者分为三组：2-3 年住院医师组（第 1 组）、4-5 年住院医师组（第 2 组）和腔内泌尿外科医生组（第 3 组）。2-3 年住院医师首次进行 PCNL，而 4-5 年住院医师首次进行仰卧 PCNL，此前曾进行俯卧 PCNL。
第 1 组的入路时间、透视时间和手术时间较高，第 2 组的时间较短，第 3 组最短（p<0.001）。术后住院时间和需要额外治疗的时间较短（p<0.001），第 1 组到第 3 组的结石清除率（SFR）增加（p<0.001）。第 1 组的并发症发生率最高（p=0.002）。第 1 组患者的病例数增加时，SFR 率增加。第 1 组的 SFR 率在 46-60 例时稳定，第 2 组的 SFR 率在 31-45 例时稳定。
第 1 组观察到的并发症最多，第 3 组最少。
在 2-3 年住院医师中，随着经验的增加，入路时间和透视时间减少。在 4-5 年住院医师中，由于他们在俯卧 PCNL 方面的专业知识，随着手术次数的增加，手术时间和透视时间减少。2-3 年住院医师的 SFR 在 46-60 例后更高，4-5 年住院医师的 SFR 在 31-45 例后更高。
