Does Previous Robot-assisted Radical Prostatectomy Experience Affect Outcomes at Robot-assisted Radical Cystectomy? Results from the International Robotic Cystectomy Consortium - 20/08/11
Reprint requests: Khurshid A. Guru, M.D., Department of Urologic Oncology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263Résumé |
Objectives |
To evaluate the effect of previous robot-assisted radical prostatectomy (RARP) case volume on the outcomes of robot-assisted radical cystectomy. Little is known regarding the effect of previous robotic surgical experience on the implementation and execution of robot-assisted radical cystectomy.
Methods |
Using the International Robotic Cystectomy Consortium database, 496 patients were identified who had undergone robot-assisted radical cystectomy by 21 surgeons at 14 institutions from 2003 to 2009. The surgeons were divided into 4 groups according to their previous RARP experience (≤50, 51-100, 101-150, and >150 cases). The overall operative time, blood loss, lymph node yield, pathologic stage, and surgical margin status were compared among the 4 groups using chi-square analysis.
Results |
The mean operative time was 386 minutes (range 178-827). The mean estimated blood loss was 408 mL (range 25-3500). The operative time and blood loss were both significantly associated with previous RARP experience (P < .001). The mean lymph node count was 17.8 nodes (range 0-68). Lymph node yield and increased pathologic stage were significantly associated with previous RARP experience (P < .001). Finally, 34 (7.0%) of the 482 patients had a positive surgical margin. Margin status was not significantly associated with previous RARP experience (P = .089).
Conclusions |
Previous RARP case volume might affect the operative time, blood loss, and lymph node yield at robot-assisted radical cystectomy. In addition, surgeons with increased RARP experience operated on patients with more advanced tumors. Previous RARP experience, however, did not appear to affect the surgical margin status.
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| R. Thomas is owner of Gulf South Lithotripsy and a consultant to Olympus, Proctor, and Intuitive Surgical; A. Kibel is a consultant to Sonofi Adventis, Spectrum, and Envisioneering; H. Kim is an investigator for Pfizer; D. Ornstein has financial interest in Correlogies; J. Peabody is a paid lecturer for Intuitive Surgical; R. Pruthi is a paid lecturer for GTx; K. Guru is a paid lecturer for Intuitive Surgical and is an owner of, and investigator for, Simulated Surgical Systems. |
Vol 76 - N° 5
P. 1111-1116 - novembre 2010 Retour au numéro
Article précédent
- New Use of Foley Catheter for Exposing the Urethral Stump During Vesicourethral Anastomosis in Laparoscopic Radical Prostatectomy
- Wen Ming Chen, Chen Li Cheng, Yen Chuan Ou, Chen Kuan Yang, Chuan Shu Chen
- Does Robotic Technology Mitigate the Challenges of Large Prostate Size?
- Ted A. Skolarus, Ryan C. Hedgepeth, Yun Zhang, Alon Z. Weizer, Jeffrey S. Montgomery, David C. Miller, David P. Wood, Brent K. Hollenbeck
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