Opondo, Dedan4; Tefekli, Ahmet4; Esen, Tarik4; Labate, Gaston4; Sangam, Kandasami4; De Lisa, Antonello4; Shah, Hemendra4; de la Rosette, Jean4; Osther, Palle Jørn Sloth5
1 Urological Department, Institute of Regional Health Research, Det Sundhedsvidenskabelige Fakultet, SDU2 Center Lillebaelt, Institute of Regional Health Research, Det Sundhedsvidenskabelige Fakultet, SDU3 Fredericia og Kolding Sygehus, Institute of Regional Health Research, Det Sundhedsvidenskabelige Fakultet, SDU4 unknown5 Urological Department, Institute of Regional Health Research, Det Sundhedsvidenskabelige Fakultet, SDU
BACKGROUND: Previous studies have demonstrated relationships between case volumes and outcomes in surgery. Little is known about the impact of case volumes on the outcomes of percutaneous nephrolithotomy (PCNL). OBJECTIVE: To investigate the influence of case volumes on the efficacy and safety outcomes of PCNL. DESIGN, SETTING, AND PARTICIPANTS: From November 2007 to December 2009, prospective data were collected by the Clinical Research Office of the Endourological Society from consecutive patients over a 1-yr period in 96 centers globally. Data of 3933 patients in the Global PCNL study database were included in this study. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Patients were divided into low- and high-volume groups based on the median annual case volume of their respective treatment center. Preoperative characteristics and outcomes were compared between the two groups. Case volume was treated as a continuous variable. The relationship between case volume and stone-free (SF) rate, complication rate, and duration of hospital stay was explored using multivariate regression analysis. RESULTS AND LIMITATIONS: SF rates were higher in high-volume centers (82.5% vs 75.1%; p value 120 cases per year. CONCLUSIONS: Centers that perform high numbers of PCNLs per year achieve better results. Both the efficacy and safety outcomes of PCNL improve with the number of surgeries performed in a given center per year.
European Urology, 2012, Vol 62, Issue 6, p. 1181-1187