title: Reproducibility of percutaneous nephrolithotomy in the Galdakao-modified supine Valdivia position.
abstract: To demonstrate that percutaneous nephrolithotomy (PCNL) in the Galdakao-modified supine Valdivia position can be safely and effectively reproduced by different surgeons. A multicentre retrospective cross-sectional case study on 317 patients was conducted. The centres enrolled were four hospitals from the Spanish National Health System and provided data for consecutive PCNL from January 2008 to December 2010. The patients were divided into two groups: the Galdakao group (134; operated on by the master PCNL surgeon) and the other surgeons group (183; operated on by the other surgeons). The results of the technique were analysed relative to success and complications. Finally, a multivariate analysis introducing the covariates age, gender, BMI, ASA and type of stone was performed (backward stepwise logistic regression). The univariate analysis did not reveal differences in age, gender and ASA scores (p > 0.05) between the Galdakao group and the other surgeons group. The success rate was 80.6 % in the Galdakao group and 72.7 % in the other surgeons group (p = 0.01), and the complication rate was 16.4 and 26.2 %, respectively (p = 0.03). Complications were categorised based on the Clavien classification, and no differences were discovered between the groups (p = 0.19). The logistic regression confirmed only the surgeon and the stone type as independent predictive variables. PCNL in the Galdakao-modified supine Valdivia position is feasible for the use by different urologic surgeons. The results depend on the surgeon's experience, but with specific training and, maybe, selecting the simplest cases at the beginning, it is possible to achieve competitive results.
authors.affiliation: Department of Urology, Torrejon University Hospital, C/Mateo Inurria 1, 28850, Torrejón de Ardoz, Madrid, Spain. luis.llanes@yahoo.es
authors.forename: Luis
authors.initials: L
authors.lastname: Llanes
authors.forename: Javier
authors.initials: J
authors.lastname: Sáenz
authors.forename: Mikel
authors.initials: M
authors.lastname: Gamarra
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Pérez
authors.forename: Alvaro
authors.initials: A
authors.lastname: Juárez
authors.forename: Camilo
authors.initials: C
authors.lastname: García
authors.forename: José M
authors.initials: JM
authors.lastname: Arroyo
authors.forename: Gaspar
authors.initials: G
authors.lastname: Ibarluzea
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016683:Supine Position; D016896:Treatment Outcome