Original scientific paper
Ureterorenoscopic treatment of ureteral stones: influence of operator’s experience and skill on the procedure outcome
Davor Librenjak
; Department of Urology, Clinical Hospital Center Split, Split, Croatia
Marijan Šitum
; Department of Urology, Clinical Hospital Center Split, Split, Croatia
Dijana Gugić
; Department of Pathology, Forensic Medicine and Cytology, Clinical Hospital Center Split, Split, Croatia
Kazimir Milostić
; Department of Urology, Clinical Hospital Center Split, Split, Croatia
Mario Duvnjak
; Department of Urology, Clinical Hospital Center Split, Split, Croatia
Abstract
Aim To observe the influence of operating urologist’s education
and adopted skills on the outcome of ureterorenoscopy
treatment of ureteral stones.
Methods The study included 422 patients (234 men,
55.4%) who underwent ureterorenoscopy to treat ureteral
stones at the Urology Department of Clinical Hospital Center
Split, Croatia, between 2001 and 2009. All interventions
were carried out with a semi-rigid Wolf ureteroscope and
an electropneumatic generator used for lithotripsy. The
operating specialists were divided into two groups. The
first group included 4 urologists who had started learning
and performing endoscopic procedures at the beginning
of their specialization and the second group included 4
urologists who had started performing endoscopic procedures
later in their careers, on average more than 5 years
after specialization.
Results Radiology tests confirmed that 87% (208/238) of
stones were completely removed from the distal ureter,
54% (66/123) from the middle ureter, and 46% (28/61) from
the proximal ureter. The first group of urologists completed
significantly more procedures successfully, especially for
the stones in the distal (95% vs 74%; P = 0.001) and middle
ureter (66% vs 38%; P = 0.002), and their patients spent less
time in the hospital postoperatively.
Conclusion Urologists who started learning and performing
endoscopic procedures at the beginning of their specialization
are more successful in performing ureteroscopy.
It is important that young specialists receive timely and
systematic education and cooperate with more experienced
colleagues.
Keywords
urolithiasis; ureteral stone; ureterorenoscopy; surgeon’s skill
Hrčak ID:
78192
URI
Publication date:
15.2.2011.
Visits: 1.609 *