Plataforma para el registro de nefrolitotomía percutánea interinstitucional

Resumen

Introducción Las opciones para el tratamiento de cálculos renales son: la litotripcia extracorpórea, la ureterorrenoscopia flexible y la nefrolitotomía percutánea (NLP). Se ha visto que a pesar del advenimiento de nuevas tecnologías y técnicas quirúrgicas, la NLP sigue presentando una importante tasa de complicaciones, por lo que es necesario la estandarización de la técnica y la escogencia adecuada de los pacientes.

Metodología Se realizó una búsqueda de la literatura en Pubmed sin límite de fecha en la que se tuviera en cuenta palabras claves como: registro de NLP, sistemas de puntuación en NLP, características preoperatorias tenidas en cuenta en NLP. Posteriormente se socializaron dichas variables con expertos en el tema, creando una plataforma que permitiera el registro de los pacientes a quienes se les realizó NLP en el país.

Resultados Se desarrolló una plataforma web para el registro a través de dispositivos móviles, tabletas, celulares, etc. de todos los pacientes a quienes se les realizó NLP en instituciones como: FOSCAL, Fundación Santa Fé de Bogotá y Clínica Chicamocha. Una vez ingresado los datos, estos se enviaron automáticamente a una base de datos consignados en una hoja tipo Excel. Por último se creó una red de especialistas para la participación virtual por medio de la misma.

Conclusiones El registro nacional de NLP es un estudio en tiempo real y de fácil acceso que permite obtener datos relevantes de los pacientes a quienes se les realiza NLP en varias instituciones del país. Adicionalmente proporcionará bases para la creación de estudios multicéntricos y publicaciones de literatura colombiana.

Abstract

Introduction The options for the treatment of renal calculi include extracorporeal lithotripsy, flexible ureterorenoscopy, and percutaneous nephrolithotomy (PNL). Despite the advent of new technologies and surgical techniques, it has been shown that PNL continues to present an important rate of complications, highlighting the need to standardise the technique and the appropriate choice of patients.

Methodology A search of the literature was carried out, with no date limits, using key words such as: PNL record, PNL scoring systems, and preoperative characteristics taken into account in PNL. These variables were then discussed with experts on the subject. This led to the creation of a platform that would allow the registration of the patients in whom PNL was performed in the country.

Results A web platform was developed for the registration, using mobile devices, tablets, mobile phones, etc., of all the patients in whom PNL was performed in institutions such as: FOSCAL, Fundación Santa Fe de Bogotá, and Clínica Chicamocha. Once the details were entered, they were sent automatically to a database entered in an Excel sheet. Finally, a network of specialists was created for virtual participation.

Conclusions The national PNL registry is a real-time, easily accessible study that allows obtaining relevant data from the patients on whom PNL is performed in several institutions of this country. It will also provide bases for the creation of multicentre studies and publications from the Colombian literature.

Palabras Clave

nefrolitotomía - medicina basada en evidencia - motor de búsqueda - registro; Residentes - urólogos - endourología

Keywords

nephrolithotomy - evidence-based medicine - search engine - registry - medical residents - urologists - endourology

• Bibliografía

• 1 Andonian S, Okhunov Z, Shapiro EY, Smith AD, Okeke Z. Diagnostic utility and clinical value of postpercutaneous nephrolithotomy nephrostogram. J Endourol 2010; 24: 1427-1430
• 2 Segura JW, Preminger GM, Assimos DG, Dretler SP, Kahn RI, Lingeman JE. , et al. Nephrolithiasis Clinical Guidelines Panel summary report on the management of staghorn calculi. The American Urological Association Nephrolithiasis Clinical Guidelines Panel. J Urol 1994; 151: 1648-1651
• 3 Thomas K, Smith NC, Hegarty N, Glass JM. The Guy's stone score–grading the complexity of percutaneous nephrolithotomy procedures. Urology 2011; 78: 277-281 . DOI 10.1016/j.urology.2010.12. 026
• 4 Smith A, Averch TD, Shahrour K, Opondo D, Daels FPJ, Labate G. , et al. A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy. J Urol 2013; 190: 149-156
• 5 Opondo D, Gravas S, Joyce A, Pearle M, Matsuda T, Sun Y-H. , et al. Standardization of patient outcomes reporting in percutaneous nephrolithotomy. J Endourol 2014; 28: 767-774
• 6 Okhunov Z, Friedlander JI, George AK, Duty BD, Moreira DM, Srinivasan AK. , et al. S.T.O.N.E. nephrolithometry: Novel surgical classification system for kidney calculi. Urology 2013; 81: 1154-1160
• 7 Thomas K, Smith NC, Hegarty N, Glass JM. The Guy's stone score–Grading the complexity of percutaneous nephrolithotomy procedures. Urology 2011; 78: 277-281
• 8 Labadie K, Okhunov Z, Akhavein A, Moreira DM, Moreno-Palacios J, del Junco M. , et al. Evaluation and comparison of urolithiasis scoring systems in percutaneous kidney stone surgery. J Urol 2014; 193: 154-159
• 9 Mitropoulos D, Artibani W, Graefen M, Remzi M, Rouprêt M, Truss M. Reporting and grading of complications after urologic surgical procedures: An ad hoc EAU guidelines panel assessment and recommendations. Eur Urol 2012; 61: 341-349
• 10 Opondo D, Gravas S, Joyce A, Pearle M, Matsuda T, Sun Y-H. , et al. Standardization of patient outcomes reporting in percutaneous nephrolithotomy. J Endourol 2014; 28: 767-774
• 11 De la Rosette JJ, Opondo D, Daels FP, Giusti G, Serrano A, Kandasami SV. , et al. Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol 2012; 62: 246-255