Single-port laparoscopic-assisted appendectomy using the nephroscope for percutaneous nephrolithotomy at low cost

2017 ◽  
Vol 36 (3) ◽  
pp. 265 ◽  
Author(s):  
HeshamM Abdelkader ◽  
AhmedS.M. Omar ◽  
MohabG Elbarbary

Author(s):  
Flavio Roberto Takeda ◽  
Rubens Antonio Aissar Sallum ◽  
Felipe Alexandre Fernandes ◽  
Ivan Cecconello




2021 ◽  
Author(s):  
Jinpeng Shi ◽  
Xiaojian Li ◽  
Tianchi Wu ◽  
Xiangwen Wu ◽  
Xiaojin Wang ◽  
...  

Abstract Background Single-port inflatable mediastinoscopy with simultaneous laparoscopic-assisted surgery for radical esophagectomy is a promising surgical method with high technical requirements and needs team cooperation. Therefore, it is necessary to define a learning curve to guide personnel training and improve the safety of these surgical techniques.Method This study prospectively analyzed the data of 79 consecutive patients, who underwent the surgery in the Fifth Affiliated Hospital of Sun Yat-sen University from October 2016 to May 2018. All of these patients were treated by the same surgical team with extensive experience in thoracotomy, laparotomy, thoracoscopic surgery and laparoscopic surgery. The learning curve was analyzed by cumulative summation (CUSUM) analysis, with the assessment of operative time, estimated blood loss, and postoperative complications.Result By analyzing these data, The scatter diagram of every measure showing a declining situation. The learning curve decreased beginning at 25th operation. All patients were chronologically divided into two groups, the group 1(the first 25 patients) and the group 2 (the last 54 patients). The median estimated blood loss of group 2 was lower than group 1(200 vs 100ml, p<0.05). No other clinic or pathologic characteristics were observed as significantly different.Conclusion For a surgical team with extensive experience in thoracotomy, laparotomy, thoracoscopic surgery and laparoscopic surgery, 25 cases are needed before becoming proficient in this surgery.







2018 ◽  
Vol 12 (12) ◽  
Author(s):  
Jeffrey J. Leow ◽  
Anne-Sophie Valiquette ◽  
Benjamin I. Chung ◽  
Steven L. Chang ◽  
Quoc-Dien Trinh ◽  
...  

Introduction: We sought to evaluate population-based cost variations and predictors of outlier costs for percutaneous nephrolithotomy (PCNL) in the U.S. Methods: Using the Premier Healthcare Database, we identified all patients diagnosed with kidney/ureter calculus who underwent PCNL from 2003–2015. We evaluated 90-day direct hospital costs, defining high- and low-cost surgery as those >90th and <10th percentile, respectively. We constructed a multilevel, hierarchical regression model and calculated the pseudo-R2 of each variable, which translates to the percentage variability contributed by that variable on 90-day direct hospital costs. Results: A total of 114 581 patients underwent PCNL during the 12-year study period. Mean cost in the low-cost group was $5787 (95% confidence interval [CI] 5716–5856) vs. $38 590 (95% CI 37 357–39 923) in the high-cost group. Cost variations were substantially impacted by patient (63.7%) and surgical (18.5%) characteristics and less so by hospital characteristics (3.9%). Significant predictors of high costs included more comorbidities (≥2 vs. 0: odds ratio [OR] 1.81; p=0.01) and hospital region (Northeast vs. Midwest: OR 2.04; p=0.03). Predictors of low cost were hospital bed size of 300–499 beds (OR 1.35; p<0.01) and urban hospitals (OR 2.77; p=0.01). Factors less likely to be associated with lowcost PCNL were more comorbidities (Charlson Comorbidity Index [CCI] ≥2: OR 0.69; p<0.0001), larger hospitals (OR 0.61; p=0.01), and teaching hospitals (OR 0.33; p<0.0001). Conclusions: Our contemporary analysis demonstrates that patient and surgical characteristics had a significant effect on costs associated with PCNL. Poor comorbidity status contributed to high costs, highlighting the importance of patient selection.



Renal Failure ◽  
2015 ◽  
Vol 37 (4) ◽  
pp. 742-743
Author(s):  
Berkan Resorlu ◽  
Tolga Karakan ◽  
Muhammet Fatih Kilinc ◽  
Mucahit Kabar ◽  
Omer Gokhan Doluoglu


2017 ◽  
Vol 6 (2) ◽  
pp. 58-62 ◽  
Author(s):  
Soo-Jeong Lee ◽  
Hyun-Jin Roh ◽  
Hyun-Jin Cho ◽  
Sang-Hun Lee ◽  
Jun-Woo Ahn ◽  
...  


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