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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.

Authors+Show Affiliations

Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

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 -