| Impact of robotic training on surgical and pathologic outcomes during robot-assisted laparoscopic radical prostatectomy. | |
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MedLine Citation:
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PMID: 20206971 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To prospectively compare outcomes during robotic prostatectomy between surgeons with formal training in either robotic prostatectomy (RALP) or laparoscopic prostatectomy (LRP). METHODS: A total of 286 robotic prostatectomies were performed by 12 urologists between August 2008 and March 2009 as part of a new robotic surgery program at one of the largest health maintenance organizations in the United States. Four surgeons had formal training in RALP and 8 had formal training in LRP. We prospectively compared surgical and pathologic outcomes between these 2 groups of surgeons. RESULTS: The 4 RALP surgeons performed 121 RALPs and the 8 LRP surgeons performed 165 RALPs. Patient demographics were similar between groups. The robot-naive group had significantly more clinical stage T1c than the robot-trained group (87.9% vs 74.4%, P = .003). Prostatectomy parameters were similar between the 2 groups of surgeons in terms of prostate size, Gleason score, pathologic stage, and estimated blood loss. The robot-trained surgeons had significantly lower overall positive margin rates (24% vs 34.6%, P = .05) and lower margin rates in T3 tumors (38.5% vs 61.8%, P = .07), which were approximately statistically significant. There was no difference in margin rates in T2 tumors. The robot-trained surgeons had significantly lower apical margin rates (8.3% vs 21.2%, P = .003) and lateral margin rates (1.7% vs 7.3%, P = .05). The robot-trained surgeons had 10%-15% shorter procedure times. There was no difference in complication rates. CONCLUSIONS: Formal RALP training may be beneficial for surgical and pathologic outcomes of RALP compared with formal LRP training during the initial implementation of a new robotics program. |
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Authors:
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Eric O Kwon; Tricia C Bautista; Howard Jung; Reza Z Goharderakhshan; Stephen G Williams; Gary W Chien |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2010-03-05 |
Journal Detail:
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Title: Urology Volume: 76 ISSN: 1527-9995 ISO Abbreviation: Urology Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-10 Completed Date: 2010-09-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0366151 Medline TA: Urology Country: United States |
Other Details:
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Languages: eng Pagination: 363-8 Citation Subset: IM |
Copyright Information:
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Copyright 2010. Published by Elsevier Inc. |
Affiliation:
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Department of Urology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA. erickwon@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Humans Laparoscopy / methods*, standards Middle Aged Prospective Studies Prostatectomy / education*, methods*, standards Robotics / education* Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Urology. 2010 Aug;76(2):368-9; discussion 369
[PMID:
20696341
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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