Extirpative renal surgery volume in training: different roads to the (same?) destination

  • Madison Lyon
  • Nicholas G. Cost
  • Randall Meacham
  • Amanda F. SaltzmanEmail author
Original Article



To describe the overall extirpative renal surgery (ERS) training volume reported by PU and PS.


Case log data from the Accreditation Council for Graduate Medical Education (ACGME) was examined from 2013–2016 for surgery residents (Sres), urology residents (Ures), pediatric surgery fellows (PSfel) and pediatric urology fellows (PUfel). Case log information for all levels of participation over all case categories that could potentially offer ERS volume were recorded. Volume was estimated using the mean number of included cases during residency and fellowship and the sum was used to estimate total training volume. Volume between groups was compared using the student’s t test.


Case logs were included for 4447 residents (4259 Sres, 840 Ures) and fellows (188 PSfel, 71 PUfel). Mean PU volume was 113.1, which was higher than the mean PS volume of 10.3 (p < 0.001). For PU, more ERS were performed during residency than fellowship (p < 0.001). For PS the opposite was true (p < 0.001). When examining fellow training only, PUfel performed more ERS than PSfel (11.7 vs. 7.0 p < 0.001).


While previous publications note similar short-term outcomes for ERS for malignancy for PU and PS, ERS case volume during training is significantly different. Review of recent ACGME data indicate that PU have more overall experience with ERS, with most gained during residency. Additionally, PUfel performed significantly more ERS than PSfel. Further study into how these training differences affect long-term outcomes is necessary.


Training Operative experience Nephrectomy Pediatric surgery Pediatric urology 



Extirpative renal surgery


Pediatric urologist


Pediatric surgeon


Accreditation Council for Graduate Medical Education


Surgery residents


Urology residents


Pediatric surgery fellows


Pediatric urology fellows


Author contributions

ML: data collection, data analysis, manuscript writing. NC: protocol/project development, data collection, data analysis. RM: protocol/project development, data collection. AS: protocol/project development, data collection, data analysis, manuscript writing.


Etkin Family Fund of the Aspen Community Foundation.

Compliance with ethical standards

Conflict of interest

The author declares that there is no competing interest.

Ethical approval

This manuscript involves secondary analysis of de-identified registry data and thus IRB exemption was obtained.

Informed consent

No informed consent was obtained.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Madison Lyon
    • 1
  • Nicholas G. Cost
    • 1
  • Randall Meacham
    • 1
  • Amanda F. Saltzman
    • 2
    Email author
  1. 1.Division of Urology, Department of SurgeryUniversity of ColoradoAuroraUSA
  2. 2.Department of UrologyUniversity of KentuckyLexingtonUSA

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