Login to Access Video or Poster Abstract: MP50-15
Sources of Funding: none

Introduction

This study aims to investigate the relationship between surgeon case volume and outcomes after percutaneous nephrolithotomy (PCNL) within the UK._x000D_

Methods

The study used data from the BAUS registry, a mandatory databse which records information on all PCNLs performed, for 2014 and 2015. Details were retrieved from the highest quartile volume surgeons and compared to the lowest quartiule volume surgeons._x000D_ _x000D_ A series of comparisons of outcomes was then made between the high volume and the low volume groups. These outcomes included clearance on imaging at day one, blood transfusion, sepsis, complcations and post-operative length of stay. These comparisons were made for all stones accoridng to their Guys Stone Score (GSS) complexity, graded from 1-4. Comparisons were carried out using Fishers exact test._x000D_

Results

4035 PCNL were recorded. Those surgeons in the lower quartile performed 5 and 4 PCNLs or less in 2014 and 2015 respectively, and those in the upper quartile over 18 and 17 in the same time frames._x000D_ _x000D_ Overall stone clearance, by imaging at day one, was higher in the higher volume surgeons for GSS1 (93% v 80%, p=0.01), GSS2 (74% v 63%, p=0.01), GSS3 (66% v 50%) and GSS 4 stones (37% v 35%, p=0.41), although not significantly for the latter. There was no difference in post op transfusion rates or sepsis. Conplication rates were higher for lower volume surgeons (9.6% v 4.7%, p=0.009)._x000D_

Conclusions

Lower volume surgeons have higher complcations rates and lower stone free rates after PCNL. _x000D_

Funding

none