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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Article info
Publication history
Published online: August 16, 2010
Accepted:
May 5,
2010
Received:
November 24,
2009
Footnotes
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.
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
