Surgical learning curve for open radical prostatectomy: Is there an end to the learning curve?

World Journal of Urology
Alexander KretschmerDerya Tilki

Abstract

To analyze the impact of surgeon's experience on surgical margin status, postoperative continence and operative time after radical prostatectomy (RP) in a surgeon who performed more than 2000 open RP. We retrospectively analyzed 2269 patients who underwent RP by one surgeon from April 2004 to June 2012. Multivariable logistic models were used to quantify the impact of surgeon's experience (measured by the number of prior performed RP) on surgical margin status, postoperative continence and operative time. Negative surgical margin rate was 86 % for patients with pT2 stage, and continence rate at 3 years after RP was 94 %. Patients with negative surgical margin had lower preoperative PSA level (p = 0.02), lower pT stage (p < 0.001) and lower Gleason score (p < 0.001). The influence of the experience of the surgeon was nonlinear, positive and highly significant up to 750 performed surgeries (75-90 % negative surgical margin) (p < 0.01). The probability of continence rises significantly with surgeon's experience (from 88-96 %) (p < 0.05). A reduction in operative time (90-65 min) per RP was observed up to 1000 RP. In the present study, we showed evidence that surgeon's experience has a strong positive impact on pathologic and funct...Continue Reading

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Citations

Jun 18, 2015·Der Urologe. Ausg. A·L Weißbach
Mar 23, 2018·Neurourology and Urodynamics·Markus GrabbertRicarda M Bauer
Nov 5, 2016·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Alexander KretschmerAlexander Karl
Jul 1, 2019·World Journal of Urology·Mitchell G Goldenberg
May 12, 2017·World Journal of Urology·Annika HerlemannStefan Tritschler

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