Analyzing Learning Curve for Supine Percutaneous Nephrolithotomy in Urology Resident Training Programme: Comparative Analysis

Author:

Arıkan Yusuf1,Danacioğlu Yavuz Onur2,Özlü Deniz Noyan3,Koraş Ömer1,Emir Büşra4,Keskin Mehmet Zeynel1

Affiliation:

1. Izmir Tepecik Training and Research Hospital

2. Bakırkoy Dr. Sadi Konuk Tepecik Training and Research Hospital

3. Bitlis State Hospital

4. Izmir Kâtip Çelebi University

Abstract

Abstract

Introduction This article attempts to provide a comprehensive review of the learning objectives and importance of the supine percutaneous nephrolithotomy (PCNL) technique. Material Method We retrospectively reviewed the cases of Supine PCNL between January 2018 and January 2024. We divided the groups into 3: residents between 1–3 years (Group 1), residents between 4–5 years (Group 2), and specialists (Group 3). The 1–3-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. Results 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. cases. The most complications were observed in Group 1 and the least in Group 3. Conclusion In 1-3-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 1-3-year residents and 31–45 cases for 4-5-year residents.

Publisher

Springer Science and Business Media LLC

Reference25 articles.

1. Supine versus prone position in percutaneous nephrolithotomy: a systematic review and meta-analysis;Birowo P;F1000Res,2020

2. Is the supine position superior to the prone position for percutaneous nephrolithotomy (PCNL)?;Zhang X;Urolithiasis,2014

3. Calcutta position: A new modified supine decubitus for supine PCNL;Choudhury S;Urologia,2024

4. Endoscopic guided PCNL in the prone split-leg position versus supine PCNL: a comparative analysis stratified by Guy's stone score;Batagello CA;Can J Urol,2019

5. Influence of Webinar-Based Learning on Practice of Percutaneous Nephrolithotomy: Outcomes of a Global Survey;Lim EJ;J Endourol,2022

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