High-volume surgeons decrease operating time in robot-assisted radical prostatectomy: results in 1229 patients.
Minerva Urol Nephrol
; 76(3): 312-319, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38920011
ABSTRACT
BACKGROUND:
The aim is to evaluate factors impacting operating time (OT) during robot-assisted radical prostatectomy (RARP) with or without extended pelvic lymph node dissection (ePLND) for prostate cancer.METHODS:
Overall, 1289 patients underwent RARP from January 2013 to December 2021. ePLND was performed in 825 cases. Factors potentially associated with OT variations were assessed. Three low-volume (LVS) and two high-volume surgeons (HVS) performed the procedures. A linear regression model was computed to assess associations with OT variations.RESULTS:
When RARP was performed by HVS an OT decrease was observed independently by significant clinical (Body Mass Index [BMI]; prostate volume [PV]) and anatomical/perioperative features (prostate weight [PW]; intraoperative blood loss [BL]) both in clinical (change in OT -42.979 minutes; 95% CI -51.789; -34.169; P<0.0001) and anatomical/perioperative models (change in OT -40.020 minutes; 95% CI -48.494; -31.587; P<0.0001). A decreased OT was observed in clinical (change in OT -27.656 minutes; 95% CI -33.449; -21.864; P<0.0001) and anatomical/perioperative (change in OT -24.935 minutes; 95% CI -30.562; -19.308; P<0.0001) models also in case of RARP with ePLND performed by HVS, independently by BMI, PV, PSA as well as for PW, seminal vesicle invasion, positive surgical margins, and BL.CONCLUSIONS:
In a tertiary academic referral center, OT decreased when RARP was performed by HVS, independently of adverse clinical and anatomical/perioperative factors. Available OT loads can be planned to optimize waiting lists, teaching tasks, operative costs, and surgeon's volume.
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Base de dados:
MEDLINE
Assunto principal:
Prostatectomia
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Neoplasias da Próstata
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Duração da Cirurgia
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Procedimentos Cirúrgicos Robóticos
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Excisão de Linfonodo
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article