Impact of Surgeon and Hospital Volume on the Safety of Robot-Assisted Radical Prostatectomy: A Multi-Institutional Study Based on a National Database

Yosuke Hirasawa, Kunihiko Yoshioka, Yasutomo Nasu, Masumi Yamamoto, Shiro Hinotsu, Atsushi Takenaka, Masato Fujisawa, Ryoichi Shiroki, Keiichi Tozawa, Satoshi Fukasawa, Akira Kashiwagi, Katsunori Tatsugami, Masaaki Tachibana, Toshiro Terachi, Momokazu Gotoh

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Introduction: We aimed to perform a multi-institutional study using a national database led by the Japanese Society of Endourology to investigate the effect of surgeon or hospital volume on the safety of robot-assisted radical prostatectomy (RARP). Materials and Methods: Clinical data of 3,214 patients who underwent RARP for the treatment of clinically localized prostate cancer between April 2012 and March 2013 in Japan were evaluated. Surgical outcomes and all intra-A nd perioperative complications were collected. Results: The intraoperative complication rate was 0.56%. In a total number of 241 patients, 261 perioperative complications were observed. The following percentages of patients presented the Clavien-graded complications: 7.2%, grades 1-2; 0.84%, grade 3; and 0.093%, grade 4a. No cases of multiple organ dysfunction or death (grades 4b and 5) were found. Multivariable logistic regression analysis showed that the hospital volume (OR 3.6; p = 0.010) for intraoperative complications and surgeon volume (OR 0.19; p < 0.0001) and extended lymph node discectomy (OR 3.9; p < 0.0001) for perioperative complications were significant independent risk factors. Conclusions: Hospital volume for intraoperative complications and surgeon volume and extended lymph node dissection for perioperative complications were significantly associated with increased risk of each complication in RARP.

Original languageEnglish
Pages (from-to)334-342
Number of pages9
JournalUrologia Internationalis
Volume98
Issue number3
DOIs
Publication statusPublished - Apr 1 2017

Keywords

  • Learning curve
  • Multi-institutional study
  • Robot-assisted radical prostatectomy
  • Safety

ASJC Scopus subject areas

  • Urology

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    Hirasawa, Y., Yoshioka, K., Nasu, Y., Yamamoto, M., Hinotsu, S., Takenaka, A., Fujisawa, M., Shiroki, R., Tozawa, K., Fukasawa, S., Kashiwagi, A., Tatsugami, K., Tachibana, M., Terachi, T., & Gotoh, M. (2017). Impact of Surgeon and Hospital Volume on the Safety of Robot-Assisted Radical Prostatectomy: A Multi-Institutional Study Based on a National Database. Urologia Internationalis, 98(3), 334-342. https://doi.org/10.1159/000460304