MP27-16 COMPARISON OF ACCESS RELATED COMPLICATIONS: RADIOLOGIST VS UROLOGIST OBTAINED PERCUTANEOUS RENAL ACCESS.

Abstract

You have accessJournal of UrologyStone Disease: Therapy III1 Apr 2014MP27-16 COMPARISON OF ACCESS RELATED COMPLICATIONS: RADIOLOGIST VS UROLOGIST OBTAINED PERCUTANEOUS RENAL ACCESS. Johann Ingimarsson, Seth Bechis, Rachel Moses, Elizabeth Johnson, Brian Eisner, and Vernon Pais Johann IngimarssonJohann Ingimarsson More articles by this author , Seth BechisSeth Bechis More articles by this author , Rachel MosesRachel Moses More articles by this author , Elizabeth JohnsonElizabeth Johnson More articles by this author , Brian EisnerBrian Eisner More articles by this author , and Vernon PaisVernon Pais More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.379AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Percutaneous renal access (PRA) is the cornerstone to successful percutaneous renal surgery (PRS). This critical step is performed by interventional radiologists (IR) in 75-90% of cases. Perception that IR possess improved skills has been cited as rationale for this practice pattern. However, few domestic reports have directly compared incidence of PRA-related complications between IR and urologists. The objective of this study is to identify if there are differences in complications between the groups. METHODS 631 patients undergoing PRS at an academic center between 2005 and 2012 were retrospectively reviewed. PRA was obtained by a group of fellowship-trained IR (group 1, n=278) or a fellowship-trained endourologist (group 2, n=353). Access site, secondary procedures and stone free rates were recorded. Complications compared between groups included bleeding necessitating transfusion or angioembolization, hydrothorax/pneumothorax, UPJ disruptions and failed access. RESULTS Mean patient age was 53±16 years and 55±15 years in groups 1 and 2 (p=0.03). Higher access (10th or 11th intercostal spaces) was less commonly obtained in group 1 than group 2 (14% vs 47%) (p<0.001). Overall, PRA- related complications occurred in 6.1 and 4.8% in groups 1 and 2 (p = 0.4). No statistical difference was detected between groups in any sub-category of PRA-related complications, including transfusion (1.8% vs 2.2 %), angioembolization (2.5% vs 1.4%), hydrothorax or pneumothorax requiring intervention (0.7% vs 1.1%) and failed access (2.2% vs 1.1%). One death from hemorrhage with multi-organ failure occurred in group 1. Patients in group 1 underwent more secondary procedures to achieve a stone free state (38 vs 21%, p<0.01). CONCLUSIONS We report one of the largest American of IR and urologist PRA. Despite patient in the endourology group being older and more often having access obtained through the 10th or 11th intercostal spaces, no significant difference in complications was identified. We confirm that PRA may be safely obtained by urologists in a centralized stone program. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e280 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Johann Ingimarsson More articles by this author Seth Bechis More articles by this author Rachel Moses More articles by this author Elizabeth Johnson More articles by this author Brian Eisner More articles by this author Vernon Pais More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...