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Learning curve for radical retropubic prostatectomy.
Int Braz J Urol. 2011 Jan-Feb; 37(1):67-74; discussion 75-8.IB

Abstract

PURPOSE

The learning curve is a period in which the surgical procedure is performed with difficulty and slowness, leading to a higher risk of complications and reduced effectiveness due the surgeon's inexperience. We sought to analyze the residents' learning curve for open radical prostatectomy (RP) in a training program.

MATERIALS AND METHODS

We conducted a prospective study from June 2006 to January 2008 in the academic environment of the University of Sao Paulo. Five residents operated on 184 patients during a four-month rotation in the urologic oncology division, mentored by the same physician assistants. We performed sequential analyses according to the number of surgeries, as follows: ≤ 10, 11 to 19, 20 to 28, and ≥ 29.

RESULTS

The residents performed an average of 37 RP each. The average psa was 9.3 ng/mL and clinical stage T1c in 71% of the patients. The pathological stage was pT2 (73%), pT3 (23%), pT4 (4%), and 46% of the patients had a Gleason score 7 or higher. In all surgeries, the average operative time and estimated blood loss was 140 minutes and 488 mL. Overall, 7.2% of patients required blood transfusion, and 23% had positive surgical margins.

CONCLUSION

During the initial RP learning curve, we found a significant reduction in the operative time; blood transfusion during the procedures and positive surgical margin rate were stable in our series.

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Authors+Show Affiliations

Saito FJ
Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Dall'Oglio MF
No affiliation info available
Ebaid GX
No affiliation info available
Bruschini H
No affiliation info available
Chade DC
No affiliation info available
Srougi M
No affiliation info available

MeSH

AdenocarcinomaAdultAgedBlood TransfusionClinical CompetenceHumansInternship and ResidencyIntraoperative ComplicationsLearning CurveMaleMiddle AgedNeoplasm GradingProspective StudiesProstatectomyProstatic NeoplasmsTime FactorsTreatment Outcome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21385482

Citation

Saito, Fernando J A., et al. "Learning Curve for Radical Retropubic Prostatectomy." International Braz J Urol : Official Journal of the Brazilian Society of Urology, vol. 37, no. 1, 2011, pp. 67-74; discussion 75-8.
Saito FJ, Dall'Oglio MF, Ebaid GX, et al. Learning curve for radical retropubic prostatectomy. Int Braz J Urol. 2011;37(1):67-74; discussion 75-8.
Saito, F. J., Dall'Oglio, M. F., Ebaid, G. X., Bruschini, H., Chade, D. C., & Srougi, M. (2011). Learning curve for radical retropubic prostatectomy. International Braz J Urol : Official Journal of the Brazilian Society of Urology, 37(1), 67-74; discussion 75-8.
Saito FJ, et al. Learning Curve for Radical Retropubic Prostatectomy. Int Braz J Urol. 2011 Jan-Feb;37(1):67-74; discussion 75-8. PubMed PMID: 21385482.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Learning curve for radical retropubic prostatectomy. AU - Saito,Fernando J A, AU - Dall'Oglio,Marcos F, AU - Ebaid,Gustavo X, AU - Bruschini,Homero, AU - Chade,Daher C, AU - Srougi,Miguel, PY - 2010/05/25/accepted PY - 2011/3/10/entrez PY - 2011/3/10/pubmed PY - 2011/12/17/medline SP - 67-74; discussion 75-8 JF - International braz j urol : official journal of the Brazilian Society of Urology JO - Int Braz J Urol VL - 37 IS - 1 N2 - PURPOSE: The learning curve is a period in which the surgical procedure is performed with difficulty and slowness, leading to a higher risk of complications and reduced effectiveness due the surgeon's inexperience. We sought to analyze the residents' learning curve for open radical prostatectomy (RP) in a training program. MATERIALS AND METHODS: We conducted a prospective study from June 2006 to January 2008 in the academic environment of the University of Sao Paulo. Five residents operated on 184 patients during a four-month rotation in the urologic oncology division, mentored by the same physician assistants. We performed sequential analyses according to the number of surgeries, as follows: ≤ 10, 11 to 19, 20 to 28, and ≥ 29. RESULTS: The residents performed an average of 37 RP each. The average psa was 9.3 ng/mL and clinical stage T1c in 71% of the patients. The pathological stage was pT2 (73%), pT3 (23%), pT4 (4%), and 46% of the patients had a Gleason score 7 or higher. In all surgeries, the average operative time and estimated blood loss was 140 minutes and 488 mL. Overall, 7.2% of patients required blood transfusion, and 23% had positive surgical margins. CONCLUSION: During the initial RP learning curve, we found a significant reduction in the operative time; blood transfusion during the procedures and positive surgical margin rate were stable in our series. SN - 1677-6119 UR - https://www.unboundmedicine.com/medline/citation/21385482/Learning_curve_for_radical_retropubic_prostatectomy_ L2 - http://www.brazjurol.com.br/january_february_2011/DallOglio_67_78.htm DB - PRIME DP - Unbound Medicine ER -