| Autor: |
Rascu, S., Sima, C., Toma, C., Aurelian, J., Diaconescu, D., Petca, R., Constantin, T., Danau, R., Predoiu, G., Merticariu, M., Jinga, V., Badescu, D. |
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| Zdroj: |
Romanian Journal of Urology; 2023, Issue 1, p45-50, 6p |
| Abstrakt: |
Introduction and Objectives. Flexible ureterorenoscopy (f-URS) gained a lot of field in treating reno-ureteral lithiasis, with a clear indication for kidney stones smaller than 20 mm with an acceptable stone free rate (SFR) compared to its complications, but also with a specific learning curve. The goal of this study is to investigate the learning curve in f-URS and its impact on success and complication rates. Materials and Methods. 60 patients from a tertiary care urology clinic who underwent f-URS were enrolled in this prospective study and divided into two study groups of 30 patients each based on the period of time the surgery was performed. Patients' and lithiasis characteristics, f-URS-related parameters, hospital stay time, SFR and complications were gathered into a database for comparison and statistical assessment of the differences. Results. The two study groups were comparable, regarding the age, sex, BMI, stone location, stone density and stone sizes. Time passed till the introduction of the flexible ureteroscope was 18.5 minutes in group 1 versus 12.4 minutes in group 2 (p = 0.001). The fluoroscopy time was shorter in group 2 40.8 versus 83 seconds (p = 0.001). The operative time decreased significantly from 49.2 minutes to 32 minutes in the second group (p = 0.001). Complication rate and hospital stay showed no major difference between the two patient groups, but the SFR was significantly improved in the latest study group-86.66% versus 66%. Conclusions. Flexible ureteroscopy is a minimally invasive surgical intervention that requires experience and surgical skills gained after overpassing a specific learning curve. Our study shows that a good level of proficiency might be obtained after the completion of at least 30 cases in terms of operative time, fluoroscopy time, complication, and stone free rates. Further standardized prospective trials ought to be conducted to better characterize assess the precise learning curve. [ABSTRACT FROM AUTHOR] |
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