Category: Clinical Stones: PCNL

MP7-5 - Single centre v pooled outcome data in percutaneous nephrolithotomy (PCNL). What is important for the patient and informed consent ? We compare our 16yr Single U.K. Centre data to large Single Centre and Pooled Multicentre outcomes

Fri, Sep 21
10:00 AM - 12:00 PM

Introduction & Objective :

Introduction


Definitions of high throughput stone units differ in the UK and internationally and despite


international and national pooled PCNL outcome data being available for some years, there


are still very few series reporting over 500 cases.


Methods :

Methods


A combination of retrospective and prospective data were collated from 2000-2016 and


compared against large single centre international series And pooled multicentre data.


Results :

Results


Data were available on 801 unique cases performed between 2000 and 2016, mean age


55.2 (S.D. = 14.8) (range 17-93).


The mean change in haemoglobin was found to be 1.65 g/dL +/- 0.05, n= 630. 27 patients


required transfusion post –operatively (3.7%).


In 470 cases, the information on pre-op UTI was available. 119 (25%) demonstrated


evidence of bacteriuria pre-operatively. The most common isolated species were E. Coli and


Proteus. Those infected did demonstrate, on average, a higher drop in Hb during surgery;


however, this difference was not found to be statistically significant.


Where the information was available, creatinine rise during surgery was calculated. The


mean rise was found to be 15.21 umol/L (S.E.: 2.08, n = 208). The mean drop in eGFR was


estimated to be 7.35 ml/min/1.73m2 (+/- 0.895, n=205).


In total, 8 cases of 801 (1%) required admission to higher level care. There was 1 small


bowel puncture and 1 pleural perforations causing haemo pneumothorax.


Sub-selective embolization occurred in 1 case 0.12 % and there were no peri-operative deaths


in this series.


Published data comparing single centres with >500 cases as multicentre pooled data will be presented.


Conclusions :

Conclusion


In the age of transparent informed consent, single centre rather than pooled outcome data


should be utilised

Andreas O. Auer

Urology Registrar (ST6)
Queen Alexandra Hospital Portsmouth
Southampton, England, United Kingdom

Michal Barabas

Medical Student
University of Cambridge
Cambridge, England, United Kingdom

Richard Cetti

Consultant
Launceston, Tasmania, Australia

Ann Rogers

Queen Alexandra Hospital Portsmouth
Prtsmouth, England, United Kingdom

Byron Walmsley

Queen Alexandra Hospital
Portsmouth, England, United Kingdom

Stephen Keoghane

Consultant
Bury St Edmunds, England, United Kingdom