Cumulative summation graphs are a useful tool for monitoring positive surgical margin rates in robot-assisted radical prostatectomy.
BJU Int
; 107(10): 1648-52, 2011 May.
Article
em En
| MEDLINE
| ID: mdl-20880131
ABSTRACT
OBJECTIVE:
⢠To explore the usefulness of cumulative summation (CUSUM) graphs for monitoring positive surgical margin (PSM) rates during a surgeon's transition from open to robot-assisted radical prostatectomy (RARP). PATIENTS ANDMETHODS:
⢠Data were prospectively collected from patients undergoing RARP by a single surgeon. ⢠Preoperatively all patients were either low or moderate risk under the D'Amico classification system. ⢠A CUSUM graph was charted retrospectively to analyse the PSM rate in patients undergoing RARP for pathological stage T2 (pT2) disease. ⢠Acceptable and unacceptable PSM rates were set at 10% and 15% respectively.RESULTS:
⢠From a cohort of 226 patients, 158 patients with pT2 disease were selected. The mean (range) age of these patients was 59.2 (39-73) years, the median (range) Gleason score was 6 (4-9), the mean (range) PSA was 6.43 (0.52-17.5) ng/mL and the mean (range) prostate volume was 44 (18-120) cm(3). In all, 21 patients had PSMs (13%). ⢠CUSUM graphs were produced and clearly demonstrated the change in PSM rate over time.CONCLUSION:
⢠CUSUM graphs are a novel and useful visual representation of the learning curve for surgeons. ⢠PSM rates in patients with pT2 disease are a good outcome to monitor using CUSUM graphs as they are binary and lack the confounding factors associated with other outcomes such as continence and erectile dysfunction. ⢠We advocate the use of CUSUM graphs as a method of quality assurance with the introduction of a robotics programme.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Prostatectomia
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Neoplasias da Próstata
/
Robótica
Limite:
Adult
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Aged
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
BJU Int
Assunto da revista:
UROLOGIA
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Canadá