Mp78-08 a One-Year Clinical Fellowship in Endourology Positively Affects Surgical Outcomes of Stone Patients Treated With Ureteroscopy and Ho:yag Laser Lithotripsy

You have accessJournal of UrologyStone Disease: Surgical Therapy (Including ESWL) V (MP78)1 May 2024MP78-08 A ONE-YEAR CLINICAL FELLOWSHIP IN ENDOUROLOGY POSITIVELY AFFECTS SURGICAL OUTCOMES OF STONE PATIENTS TREATED WITH URETEROSCOPY AND HO:YAG LASER LITHOTRIPSY Luca Villa, Luigi Candela, Christian Corsini, Armando Stabile, Eugenio Ventimiglia, Alberto Briganti, Francesco Montorsi, and Andrea Salonia Luca VillaLuca Villa , Luigi CandelaLuigi Candela , Christian CorsiniChristian Corsini , Armando StabileArmando Stabile , Eugenio VentimigliaEugenio Ventimiglia , Alberto BrigantiAlberto Briganti , Francesco MontorsiFrancesco Montorsi , and Andrea SaloniaAndrea Salonia View All Author Informationhttps://doi.org/10.1097/01.JU.0001008856.05210.73.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The learning curve of flexible ureteroscopy and Ho:YAG laser lithotripsy (URS) is considered quite short (n=50 procedures). In this context, the need for prolonged endourological training can be questioned. We sought to evaluate the impact of a one-year clinical fellowship in endourology (CFE) on the surgical outcomes of stone patients treated with URS. METHODS: We identified 303 stone patients treated with URS from January 2018 to June 2022 at a single tertiary care referral center by five experienced surgeons (ES) (more than 50 procedures/each). Of those, two of them had a CFE at a stone referral center (Tenon Hospital, Paris, France). Optimal surgical outcome (OSO) was defined as the presence of residual fragments ≤4 mm at 1-month postoperative imaging (Abdomen Ultrasound (US) + X-Ray or CT scan). Descriptive statistics explored patients' characteristics and evaluated the rate of OSO according to the attendance of CFE. Uni- and multivariate logistic regression analyses (UVA and MVA) tested the impact of stone characteristics, surgical data, CFE and imaging technique on the rate of OSO. LOWESS curve explored the graphical association between stone size and the multivariable adjusted probability of OSO in the two groups of surgeons. RESULTS: Median (IQR) stone size was 11 mm (8-15). Of 303 patients, 208 (68.6%) were treated by the two surgeons who attended CFE. OSO was achieved in 66.3% and 51.6% of patients treated by ES with and without CFE, respectively (p=0.01). At UVA, CFE (OR=1.78; 95%CI=1.09-2.90), stone diameter (OR=0.92; 95%CI=0.88-0.96), stone location (kidney vs. ureter; OR=0.34; 95%CI=0.21-0.58), imaging technique (TC vs. US+X-Ray, OR=0.28; 95%CI=0.16–0.47) predicted OSO achievement (all p≤0.02). At MVA analyses, CFE was associated with OSO (OR=2.24; 95%CI=1.29-3.88; p<0.01), along with the others aforementioned variables. LOWESS curve showed that the greater the stone size, the greater the difference of OSO in the two groups of surgeons (Figure 1). CONCLUSIONS: CFE affects surgeon performances, with an almost 2.5-fold high rate of OSO achievement compared to surgeons supposed to have already completed their learning curve. The positive impact of CFE appeared to be higher in patients with a high stone burden. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1266 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Luca Villa More articles by this author Luigi Candela More articles by this author Christian Corsini More articles by this author Armando Stabile More articles by this author Eugenio Ventimiglia More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement PDF downloadLoading ...