CUSUM analysis of the learning curve of percutaneous nephrolithotomy
Li Juan
Gao Fan
He Xucheng
Zhao Yue
Liu Haitao
Fan Weizhe
Liu Qiming
Mai Haixing
Zhang Xu
Shen dan
Abstract：Objective:To explore the learning curve of percutaneous nephrolithotomy(PCNL)for stone frag-mentation and extraction.Methods:The clinical data of 27 patients who underwent PCNL performed by the same surgeon from June 2023 to November 2023 in our hospital were analyzed using cumulative sum analysis(CUSUM).All patients underwent ultrasound-guided puncture for PCNL.The CUSUM learning curve was fitted and the good-ness of fit was assessed using R2.The differences in baseline data and perioperative data at different stages of the learning curve were compared to summarize the number of cases needed to transition from the learning phase to the proficient phase of PCNL.Results:All patients successfully completed the surgery with operation time of(128.22±37.19)minutes(range:60-212 minutes).The cumulative sum showed a decreasing trend with an increas-ing number of cases.The best fit for the learning curve was a cubic curve,with a goodness of fit coefficient of R2=0.585.The fitted equation was CUSUM(27)=-0.008n3-0.049n2+4.231n+57.407(where n represents the number of cases).The fitted curve reached its peak at the 11th case,dividing the learning curve into two stages.There were significant statistical differences in indwelling catheter time(P=0.007)and postoperative hospital stay(P=0.022)between the patients of two stages.Conclusion:Precise analysis of the learning curve of PCNL for stone fragmenta-tion and extraction in 27 cases using CUSUM analysis indicates that proficiency in this technique requires a cumula-tive experience of 11 cases.
Keywords：CUSUM analysiskidney calculipnephrolithotomyercutaneouslearning curve
Publication Date：2024-06-05
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 150-154 )