Modular training for percutaneous nephrolithotripsy: The safe way to go
Identifieur interne : 000729 ( Main/Exploration ); précédent : 000728; suivant : 000730Modular training for percutaneous nephrolithotripsy: The safe way to go
Auteurs : Panagiotis Kallidonis [Grèce] ; Iason Kyriazis [Grèce] ; Marinos Vasilas [Grèce] ; Vasilis Panagopoulos [Grèce] ; Ioannis Georgiopoulos [Grèce] ; Mehmet Ozsoy [Autriche] ; Jens-Uwe Stolzenburg [Allemagne] ; Christian Seitz [Autriche] ; Evangelos Liatsikos [Grèce]Source :
- Arab Journal of Urology [ 2090-598X ] ; 2015.
Abstract
Objectives should be describe a modular training scheme (MTS) which aims to provide training in percutaneous nephrolithotripsy (PCNL) and ensure the safety of the patients.
Two trainees with no experience in PCNL attended the MTS under the supervision of an experienced mentor. The MTS included five modules, comprising an initial animal laboratory course (using pigs), to acquire basic skills (Module 1), and Modules 2–5 included making the puncture, tract dilatation, single-stone and large-stone management in clinical cases, respectively. Each participant progressed from one module to the next under constant mentoring and evaluation by the mentor. When the trainees completed the MTS they proceeded to perform 60 PCNL procedures independently while the mentor performed 25 for comparison purposes. A global rating scale was used for the objective evaluation of the trainees. Peri-operative variables were recorded and statistically compared as appropriate. Statistical significance was defined as
One pig and 16 patients, and two pigs and 22 patients, were necessary to complete the MTS by each subject. There were no significant differences among the characteristics of the independently performed operations. The duration of surgery and fluoroscopy achieved a plateau similar to those of the mentor after ≈ 30 patients. The decrease in haemoglobin level, stone-free and complication rates in the patients were similar among the two trainees and the mentor. The complication rate of the trainees and the mentor never exceeded 13.3%.
The MTS successfully combined animal and stepwise clinical training based on a standardised technique and objective evaluation.
Url:
DOI: 10.1016/j.aju.2015.07.005
PubMed: 26609446
PubMed Central: 4656800
Affiliations:
- Allemagne, Autriche, Grèce
- District de Leipzig, Saxe (Land), Vienne (Autriche)
- Leipzig, Vienne (Autriche)
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Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Urology, Medical University of Vienna, Vienna</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Liatsikos, Evangelos" sort="Liatsikos, Evangelos" uniqKey="Liatsikos E" first="Evangelos" last="Liatsikos">Evangelos Liatsikos</name><affiliation wicri:level="1"><nlm:aff id="af005">Department of Urology, University of Patras, Patras, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Urology, University of Patras, Patras</wicri:regionArea><wicri:noRegion>Patras</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26609446</idno><idno type="pmc">4656800</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4656800</idno><idno type="RBID">PMC:4656800</idno><idno type="doi">10.1016/j.aju.2015.07.005</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">001B75</idno><idno type="wicri:Area/Pmc/Curation">001B75</idno><idno type="wicri:Area/Pmc/Checkpoint">000454</idno><idno type="wicri:Area/Ncbi/Merge">003D89</idno><idno type="wicri:Area/Ncbi/Curation">003D89</idno><idno type="wicri:Area/Ncbi/Checkpoint">003D89</idno><idno type="wicri:doubleKey">2090-598X:2015:Kallidonis P:modular:training:for</idno><idno type="wicri:Area/Main/Merge">000729</idno><idno type="wicri:Area/Main/Curation">000729</idno><idno type="wicri:Area/Main/Exploration">000729</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Modular training for percutaneous nephrolithotripsy: The safe way to go</title><author><name sortKey="Kallidonis, Panagiotis" sort="Kallidonis, Panagiotis" uniqKey="Kallidonis P" first="Panagiotis" last="Kallidonis">Panagiotis Kallidonis</name><affiliation wicri:level="1"><nlm:aff id="af005">Department of Urology, University of Patras, Patras, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Urology, University of Patras, Patras</wicri:regionArea><wicri:noRegion>Patras</wicri:noRegion></affiliation></author><author><name sortKey="Kyriazis, Iason" sort="Kyriazis, Iason" uniqKey="Kyriazis I" first="Iason" last="Kyriazis">Iason Kyriazis</name><affiliation wicri:level="1"><nlm:aff id="af005">Department of Urology, University of Patras, Patras, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Urology, University of Patras, Patras</wicri:regionArea><wicri:noRegion>Patras</wicri:noRegion></affiliation></author><author><name sortKey="Vasilas, Marinos" sort="Vasilas, Marinos" uniqKey="Vasilas M" first="Marinos" last="Vasilas">Marinos Vasilas</name><affiliation wicri:level="1"><nlm:aff id="af005">Department of Urology, University of Patras, Patras, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Urology, University of Patras, Patras</wicri:regionArea><wicri:noRegion>Patras</wicri:noRegion></affiliation></author><author><name sortKey="Panagopoulos, Vasilis" sort="Panagopoulos, Vasilis" uniqKey="Panagopoulos V" first="Vasilis" last="Panagopoulos">Vasilis Panagopoulos</name><affiliation wicri:level="1"><nlm:aff id="af005">Department of Urology, University of Patras, Patras, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Urology, University of Patras, Patras</wicri:regionArea><wicri:noRegion>Patras</wicri:noRegion></affiliation></author><author><name sortKey="Georgiopoulos, Ioannis" sort="Georgiopoulos, Ioannis" uniqKey="Georgiopoulos I" first="Ioannis" last="Georgiopoulos">Ioannis Georgiopoulos</name><affiliation wicri:level="1"><nlm:aff id="af005">Department of Urology, University of Patras, Patras, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Urology, University of Patras, Patras</wicri:regionArea><wicri:noRegion>Patras</wicri:noRegion></affiliation></author><author><name sortKey="Ozsoy, Mehmet" sort="Ozsoy, Mehmet" uniqKey="Ozsoy M" first="Mehmet" last="Ozsoy">Mehmet Ozsoy</name><affiliation wicri:level="3"><nlm:aff id="af010">Department of Urology, Medical University of Vienna, Vienna, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Urology, Medical University of Vienna, Vienna</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Stolzenburg, Jens Uwe" sort="Stolzenburg, Jens Uwe" uniqKey="Stolzenburg J" first="Jens-Uwe" last="Stolzenburg">Jens-Uwe Stolzenburg</name><affiliation wicri:level="3"><nlm:aff id="af015">Department of Urology, University of Leipzig, Leipzig, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Urology, University of Leipzig, Leipzig</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Leipzig</region><settlement type="city">Leipzig</settlement></placeName></affiliation></author><author><name sortKey="Seitz, Christian" sort="Seitz, Christian" uniqKey="Seitz C" first="Christian" last="Seitz">Christian Seitz</name><affiliation wicri:level="3"><nlm:aff id="af010">Department of Urology, Medical University of Vienna, Vienna, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Urology, Medical University of Vienna, Vienna</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Liatsikos, Evangelos" sort="Liatsikos, Evangelos" uniqKey="Liatsikos E" first="Evangelos" last="Liatsikos">Evangelos Liatsikos</name><affiliation wicri:level="1"><nlm:aff id="af005">Department of Urology, University of Patras, Patras, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Urology, University of Patras, Patras</wicri:regionArea><wicri:noRegion>Patras</wicri:noRegion></affiliation></author></analytic><series><title level="j">Arab Journal of Urology</title><idno type="ISSN">2090-598X</idno><idno type="eISSN">2090-5998</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><p>Objectives should be describe a modular training scheme (MTS) which aims to provide training in percutaneous nephrolithotripsy (PCNL) and ensure the safety of the patients.</p></sec><sec><title>Subjects and methods</title><p>Two trainees with no experience in PCNL attended the MTS under the supervision of an experienced mentor. The MTS included five modules, comprising an initial animal laboratory course (using pigs), to acquire basic skills (Module 1), and Modules 2–5 included making the puncture, tract dilatation, single-stone and large-stone management in clinical cases, respectively. Each participant progressed from one module to the next under constant mentoring and evaluation by the mentor. When the trainees completed the MTS they proceeded to perform 60 PCNL procedures independently while the mentor performed 25 for comparison purposes. A global rating scale was used for the objective evaluation of the trainees. Peri-operative variables were recorded and statistically compared as appropriate. Statistical significance was defined as <italic>P</italic> < 0.05.</p></sec><sec><title>Results</title><p>One pig and 16 patients, and two pigs and 22 patients, were necessary to complete the MTS by each subject. There were no significant differences among the characteristics of the independently performed operations. The duration of surgery and fluoroscopy achieved a plateau similar to those of the mentor after ≈ 30 patients. The decrease in haemoglobin level, stone-free and complication rates in the patients were similar among the two trainees and the mentor. The complication rate of the trainees and the mentor never exceeded 13.3%.</p></sec><sec><title>Conclusion</title><p>The MTS successfully combined animal and stepwise clinical training based on a standardised technique and objective evaluation.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Skolarikos, A" uniqKey="Skolarikos A">A. Skolarikos</name></author><author><name sortKey="Alivizatos, G" uniqKey="Alivizatos G">G. 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Unsal</name></author><author><name sortKey="Oguz, U" uniqKey="Oguz U">U. Oguz</name></author><author><name sortKey="Diri, A" uniqKey="Diri A">A. Diri</name></author><author><name sortKey="Gozen, A S" uniqKey="Gozen A">A.S. Gozen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Papatsoris, A G" uniqKey="Papatsoris A">A.G. Papatsoris</name></author><author><name sortKey="Shaikh, T" uniqKey="Shaikh T">T. Shaikh</name></author><author><name sortKey="Patel, D" uniqKey="Patel D">D. Patel</name></author><author><name sortKey="Bourdoumis, A" uniqKey="Bourdoumis A">A. Bourdoumis</name></author><author><name sortKey="Bach, C" uniqKey="Bach C">C. Bach</name></author><author><name sortKey="Buchholz, N" uniqKey="Buchholz N">N. Buchholz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Matsumoto, E D" uniqKey="Matsumoto E">E.D. Matsumoto</name></author><author><name sortKey="Hamstra, S J" uniqKey="Hamstra S">S.J. Hamstra</name></author><author><name sortKey="Radomski, S B" uniqKey="Radomski S">S.B. Radomski</name></author><author><name sortKey="Cusimano, M D" uniqKey="Cusimano M">M.D. Cusimano</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Allemagne</li><li>Autriche</li><li>Grèce</li></country><region><li>District de Leipzig</li><li>Saxe (Land)</li><li>Vienne (Autriche)</li></region><settlement><li>Leipzig</li><li>Vienne (Autriche)</li></settlement></list><tree><country name="Grèce"><noRegion><name sortKey="Kallidonis, Panagiotis" sort="Kallidonis, Panagiotis" uniqKey="Kallidonis P" first="Panagiotis" last="Kallidonis">Panagiotis Kallidonis</name></noRegion><name sortKey="Georgiopoulos, Ioannis" sort="Georgiopoulos, Ioannis" uniqKey="Georgiopoulos I" first="Ioannis" last="Georgiopoulos">Ioannis Georgiopoulos</name><name sortKey="Kyriazis, Iason" sort="Kyriazis, Iason" uniqKey="Kyriazis I" first="Iason" last="Kyriazis">Iason Kyriazis</name><name sortKey="Liatsikos, Evangelos" sort="Liatsikos, Evangelos" uniqKey="Liatsikos E" first="Evangelos" last="Liatsikos">Evangelos Liatsikos</name><name sortKey="Panagopoulos, Vasilis" sort="Panagopoulos, Vasilis" uniqKey="Panagopoulos V" first="Vasilis" last="Panagopoulos">Vasilis Panagopoulos</name><name sortKey="Vasilas, Marinos" sort="Vasilas, Marinos" uniqKey="Vasilas M" first="Marinos" last="Vasilas">Marinos Vasilas</name></country><country name="Autriche"><region name="Vienne (Autriche)"><name sortKey="Ozsoy, Mehmet" sort="Ozsoy, Mehmet" uniqKey="Ozsoy M" first="Mehmet" last="Ozsoy">Mehmet Ozsoy</name></region><name sortKey="Seitz, Christian" sort="Seitz, Christian" uniqKey="Seitz C" first="Christian" last="Seitz">Christian Seitz</name></country><country name="Allemagne"><region name="Saxe (Land)"><name sortKey="Stolzenburg, Jens Uwe" sort="Stolzenburg, Jens Uwe" uniqKey="Stolzenburg J" first="Jens-Uwe" last="Stolzenburg">Jens-Uwe Stolzenburg</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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