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Single centre versus multi-centre pooled morbidity data in PCNL and the implications for informed consent.

A Auer¹, M Barabas², J Coode-Bate²

¹Department of Urology, Portsmouth NHS Trust, Portsmouth, UK.

Scandinavian Journal of Urology

|April 1, 2020

Summary

This study on percutaneous nephrolithotomy (PCNL) outcomes found low complication rates in a single center. Utilizing single-center data is recommended for transparent patient consent regarding PCNL results.

Keywords:

PCNL consent outcome data

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Area of Science:

Urology
Nephrology
Surgical Outcomes

Background:

Existing national and international outcome data for PCNL may not represent individual hospital or surgeon performance.
There is a need for single-center data to provide more accurate outcomes for patient consent.

Purpose of the Study:

To analyze the outcomes of percutaneous nephrolithotomy (PCNL) at a single center.
To compare single-center PCNL outcomes with existing multi-center data.
To inform patient consent processes with accurate, localized outcome data.

Main Methods:

A combination of retrospective and prospective data from 2000-2016 was collated.
Data from 801 unique PCNL cases were analyzed.
Outcomes were compared against published large single and multi-center series.

Main Results:

The mean hemoglobin drop was 1.65 g/dL, with a 3.37% transfusion rate.
Pre-operative bacteriuria (25%) was noted, but not significantly linked to increased hemoglobin drop.
Low rates of complications were observed, including 1% requiring higher care, 0.75% needing embolization for bleeding, and no peri-operative deaths.

Conclusions:

Single-center outcome data for PCNL provides a more accurate reflection of performance.
Utilizing single-center data is crucial for facilitating transparent patient consent.
This study demonstrates favorable outcomes and low complication rates in PCNL performed at a single institution.