| Are urology residents adequately exposed to conservative therapies for managing small renal masses? | |
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MedLine Citation:
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PMID: 21247292 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Abstract Purpose: Increasing diagnosis of small renal masses (SRMs) necessitates trainees to be familiar with available therapies. We hypothesized that involvement in conservative treatments (ablation and/or active surveillance) occurs infrequently. Therefore, we evaluated resident exposure and participation in treatments as well as proposed management for SRMs. Methods: A survey was distributed to residents of the American Urologic Association and queried exposure to ablation and surveillance for SRMs. Three case scenarios (SRM in a healthy 55-year-old, healthy 75-year-old, and comorbid 75-year-old patient) were presented for management. Results: Two hundred fifty-seven residents responded to the survey. Two hundred thirty-four (91%) reported ablation was offered at their institution, although only 140 (54%) ever participated in this procedure. Of these, 80 (57%) were involved in fewer than five procedures. Experience with ablation did not increase at higher levels of training (U3-61%, U4-66%, and U5-63%). Two hundred twenty-four (87%) residents noted exposure to surveillance for managing SRMs, increasing from 70% in U1 to 94% in U5. When considering case scenarios, management strategy shifted significantly from extirpation to ablation or surveillance as patient age and comorbidity profile increased. In particular, almost 50% of respondents advocated ablation for SRMs in a comorbid 75-year-old patient. Conclusions: Although most residents are adequately exposed to surveillance strategies for SRMs, only 54% participated in an ablative procedure. Nonetheless, almost 50% of residents recommended ablation to manage SRMs in the aging, comorbid patient. This suggests a disconnect between training and future practice pattern. |
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Authors:
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Vanessa L Elliott; Paul H Smith; Jay D Raman |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of endourology / Endourological Society Volume: 25 ISSN: 1557-900X ISO Abbreviation: J. Endourol. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-01-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8807503 Medline TA: J Endourol Country: United States |
Other Details:
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Languages: eng Pagination: 129-33 Citation Subset: IM |
Affiliation:
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Division of Urology, Penn State Milton S. Hershey Medical Center , Hershey, Pennsylvania. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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