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ID 112031
Title Alternative
腎尿管結石に対する軟性尿管鏡による治療の合併症と学習曲線
Complications of Flex URS for Renal and Ureteral Calculi during the Learning Curve
Author
Komori, Masatsugu The University of Tokushima
Izaki, Hirofumi The University of Tokushima KAKEN Search Researchers
Daizumoto, Kei The University of Tokushima
Tsuda, Megumi The University of Tokushima
Mori, Hidehisa The University of Tokushima KAKEN Search Researchers
Kagawa, Junichiro The University of Tokushima
Fukumori, Tomoharu The University of Tokushima KAKEN Search Researchers
Sakaki, Manabu Kamei Hospital
Nakatsuji, Hiroyoshi Kamei Hospital
Hamao, Takumi Kamei Hospital
Miura, Hiroyasu Hachinohe Heiwa Hospital
Keywords
Flexible transureterolithotripsy
Learning curve
Complication
Urolithiasis
Septic shock
Content Type
Thesis or Dissertation
Description
Background: The flexible ureterorenoscope (URS) and associated devices have developed rapidly. However, despite its therapeutic benefits, URS may be associated with some complications. To the best of our knowledge, there are no studies discussing the complications of flexURS during the learning curve. Methods: A retrospective review of the records of patients who underwent flexURS from January 2005 to June 2013 was performed. To compare the complications after the introduction of flexURS, patients were divided into four groups based on the surgeon’s training experience, that is, based on the number of cases performed by the surgeon. A total of 219 cases underwent flexURS. Groups 1, 2, 3, and 4 included 35, 50, 50, and 84 cases, respectively. The complications were classified using the Clavien system (I–IV). Results: The mean operation time and stone-free rate were significantly different (p < 0.001, p = 0.013, respectively). The total complication rates were 13.6, 10, 8.3, and 3.2%, respectively (p = 0.068). The more the surgeon’s experience, the less was the complication rate. Despite our best efforts, the incidence of urosepsis was not reduced (p = 0.902). Conclusions: To reduce severe complications, it is necessary to have performed about 100 cases. Increased surgeon experience tended to decrease the risk of severe complications, but the incidence of urosepsis was not reduced.
Journal Title
Urologia Internationalis
ISSN
00421138
14230399
NCID
AA00879159
AA12786135
Publisher
S. Karger AG
Volume
95
Issue
1
Start Page
26
End Page
32
Published Date
2015-03-27
Remark
内容要旨・審査要旨・論文本文の公開
本論文は, 著者Masatsugu Komoriの学位論文として提出され, 学位審査・授与の対象となっている。
Rights
© 2015 S. Karger AG, Basel
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
ETD
MEXT report number
甲第3202号
Diploma Number
甲医第1377号
Granted Date
2018-07-26
Degree Name
Doctor of Medical Science
Grantor
Tokushima University
departments
University Hospital
Medical Sciences