Impact of Surgeon and Hospital Volume on the Safety of Robot-Assisted Radical Prostatectomy: A Multi-Institutional Study Based on a National Database
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 patie...
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| Veröffentlicht in: | Urologia internationalis 2017-01, Vol.98 (3), p.334-342 |
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| creator | Hirasawa, Yosuke Yoshioka, Kunihiko Nasu, Yasutomo Yamamoto, Masumi Hinotsu, Shiro Takenaka, Atsushi Fujisawa, Masato Shiroki, Ryoichi Tozawa, Keiichi Fukasawa, Satoshi Kashiwagi, Akira Tatsugami, Katsunori Tachibana, Masaaki Terachi, Toshiro Gotoh, Momokazu |
| description | 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- and 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. |
| doi_str_mv | 10.1159/000460304 |
| format | Article |
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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- and 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.</description><identifier>ISSN: 0042-1138</identifier><identifier>EISSN: 1423-0399</identifier><identifier>DOI: 10.1159/000460304</identifier><identifier>PMID: 28253500</identifier><language>eng</language><publisher>Basel, Switzerland</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Databases, Factual ; Humans ; Intraoperative Period ; Japan ; Lymph Node Excision ; Male ; Middle Aged ; Multivariate Analysis ; Original Paper ; Patient Safety ; Postoperative Complications ; Prostate - pathology ; Prostatectomy - methods ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - surgery ; Retrospective Studies ; Risk Factors ; Robotic Surgical Procedures - methods ; Treatment Outcome ; Urology - methods</subject><ispartof>Urologia internationalis, 2017-01, Vol.98 (3), p.334-342</ispartof><rights>2017 S. Karger AG, Basel</rights><rights>2017 S. Karger AG, Basel.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c334t-ffce961924cf4d5213c17e088fa1bb893db4adddd1eff4c671573d391441d13e3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,2424,27906,27907</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28253500$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hirasawa, Yosuke</creatorcontrib><creatorcontrib>Yoshioka, Kunihiko</creatorcontrib><creatorcontrib>Nasu, Yasutomo</creatorcontrib><creatorcontrib>Yamamoto, Masumi</creatorcontrib><creatorcontrib>Hinotsu, Shiro</creatorcontrib><creatorcontrib>Takenaka, Atsushi</creatorcontrib><creatorcontrib>Fujisawa, Masato</creatorcontrib><creatorcontrib>Shiroki, Ryoichi</creatorcontrib><creatorcontrib>Tozawa, Keiichi</creatorcontrib><creatorcontrib>Fukasawa, Satoshi</creatorcontrib><creatorcontrib>Kashiwagi, Akira</creatorcontrib><creatorcontrib>Tatsugami, Katsunori</creatorcontrib><creatorcontrib>Tachibana, Masaaki</creatorcontrib><creatorcontrib>Terachi, Toshiro</creatorcontrib><creatorcontrib>Gotoh, Momokazu</creatorcontrib><creatorcontrib>Japanese Society of Endourology</creatorcontrib><creatorcontrib>on behalf of the Japanese Society of Endourology</creatorcontrib><title>Impact of Surgeon and Hospital Volume on the Safety of Robot-Assisted Radical Prostatectomy: A Multi-Institutional Study Based on a National Database</title><title>Urologia internationalis</title><addtitle>Urol Int</addtitle><description>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- and 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.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Databases, Factual</subject><subject>Humans</subject><subject>Intraoperative Period</subject><subject>Japan</subject><subject>Lymph Node Excision</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Original Paper</subject><subject>Patient Safety</subject><subject>Postoperative Complications</subject><subject>Prostate - pathology</subject><subject>Prostatectomy - methods</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Treatment Outcome</subject><subject>Urology - methods</subject><issn>0042-1138</issn><issn>1423-0399</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpt0c1O3DAQAGCrApVl6YE7QpZ6aQ9pPbGzibltocBKFCq29Bo5_oFAEqfx5LAP0vfFq132hC-WZr4ZyzOEHAP7BpDJ74wxMWOciQ9kAiLlCeNS7pFJDKcJAC8OyGEIz4xFLPOP5CAt0oxnjE3I_0XbK43UO7och0frO6o6Q6996GtUDf3rm7G1NIbxydKlchZXa3zvK4_JPIQ6oDX0XplaR_578AEVWo2-XZ3ROf01Nlgniy5gjSPWvotoiaNZ0R8qxML1e_RWbTMXClUV40dk36km2E_be0oeLn_-Ob9Obu6uFufzm0RzLjBxTls5A5kK7YTJUuAacsuKwimoqkJyUwll4gHrnNCzHLKcGy5BCDDALZ-SL5u-_eD_jTZg2dZB26ZRnfVjKKHIhRBcxs5T8nVDdfxiGKwr-6Fu1bAqgZXrLZS7LUR7um07Vq01O_k29ghONuBFxZkPO7Cr__xu-mFxuxFlbxx_BWjbmDc</recordid><startdate>20170101</startdate><enddate>20170101</enddate><creator>Hirasawa, Yosuke</creator><creator>Yoshioka, Kunihiko</creator><creator>Nasu, Yasutomo</creator><creator>Yamamoto, Masumi</creator><creator>Hinotsu, Shiro</creator><creator>Takenaka, Atsushi</creator><creator>Fujisawa, Masato</creator><creator>Shiroki, Ryoichi</creator><creator>Tozawa, Keiichi</creator><creator>Fukasawa, Satoshi</creator><creator>Kashiwagi, Akira</creator><creator>Tatsugami, Katsunori</creator><creator>Tachibana, Masaaki</creator><creator>Terachi, Toshiro</creator><creator>Gotoh, Momokazu</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170101</creationdate><title>Impact of Surgeon and Hospital Volume on the Safety of Robot-Assisted Radical Prostatectomy: A Multi-Institutional Study Based on a National Database</title><author>Hirasawa, Yosuke ; Yoshioka, Kunihiko ; Nasu, Yasutomo ; Yamamoto, Masumi ; Hinotsu, Shiro ; Takenaka, Atsushi ; Fujisawa, Masato ; Shiroki, Ryoichi ; Tozawa, Keiichi ; Fukasawa, Satoshi ; Kashiwagi, Akira ; Tatsugami, Katsunori ; Tachibana, Masaaki ; Terachi, Toshiro ; Gotoh, Momokazu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c334t-ffce961924cf4d5213c17e088fa1bb893db4adddd1eff4c671573d391441d13e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Databases, Factual</topic><topic>Humans</topic><topic>Intraoperative Period</topic><topic>Japan</topic><topic>Lymph Node Excision</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Original Paper</topic><topic>Patient Safety</topic><topic>Postoperative Complications</topic><topic>Prostate - pathology</topic><topic>Prostatectomy - methods</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - surgery</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Treatment Outcome</topic><topic>Urology - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hirasawa, Yosuke</creatorcontrib><creatorcontrib>Yoshioka, Kunihiko</creatorcontrib><creatorcontrib>Nasu, Yasutomo</creatorcontrib><creatorcontrib>Yamamoto, Masumi</creatorcontrib><creatorcontrib>Hinotsu, Shiro</creatorcontrib><creatorcontrib>Takenaka, Atsushi</creatorcontrib><creatorcontrib>Fujisawa, Masato</creatorcontrib><creatorcontrib>Shiroki, Ryoichi</creatorcontrib><creatorcontrib>Tozawa, Keiichi</creatorcontrib><creatorcontrib>Fukasawa, Satoshi</creatorcontrib><creatorcontrib>Kashiwagi, Akira</creatorcontrib><creatorcontrib>Tatsugami, Katsunori</creatorcontrib><creatorcontrib>Tachibana, Masaaki</creatorcontrib><creatorcontrib>Terachi, Toshiro</creatorcontrib><creatorcontrib>Gotoh, Momokazu</creatorcontrib><creatorcontrib>Japanese Society of Endourology</creatorcontrib><creatorcontrib>on behalf of the Japanese Society of Endourology</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Urologia internationalis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hirasawa, Yosuke</au><au>Yoshioka, Kunihiko</au><au>Nasu, Yasutomo</au><au>Yamamoto, Masumi</au><au>Hinotsu, Shiro</au><au>Takenaka, Atsushi</au><au>Fujisawa, Masato</au><au>Shiroki, Ryoichi</au><au>Tozawa, Keiichi</au><au>Fukasawa, Satoshi</au><au>Kashiwagi, Akira</au><au>Tatsugami, Katsunori</au><au>Tachibana, Masaaki</au><au>Terachi, Toshiro</au><au>Gotoh, Momokazu</au><aucorp>Japanese Society of Endourology</aucorp><aucorp>on behalf of the Japanese Society of Endourology</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Surgeon and Hospital Volume on the Safety of Robot-Assisted Radical Prostatectomy: A Multi-Institutional Study Based on a National Database</atitle><jtitle>Urologia internationalis</jtitle><addtitle>Urol Int</addtitle><date>2017-01-01</date><risdate>2017</risdate><volume>98</volume><issue>3</issue><spage>334</spage><epage>342</epage><pages>334-342</pages><issn>0042-1138</issn><eissn>1423-0399</eissn><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- and 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.</abstract><cop>Basel, Switzerland</cop><pmid>28253500</pmid><doi>10.1159/000460304</doi><tpages>9</tpages></addata></record> |
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| ispartof | Urologia internationalis, 2017-01, Vol.98 (3), p.334-342 |
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| subjects | Adult Aged Aged, 80 and over Databases, Factual Humans Intraoperative Period Japan Lymph Node Excision Male Middle Aged Multivariate Analysis Original Paper Patient Safety Postoperative Complications Prostate - pathology Prostatectomy - methods Prostatic Neoplasms - pathology Prostatic Neoplasms - surgery Retrospective Studies Risk Factors Robotic Surgical Procedures - methods Treatment Outcome Urology - methods |
| title | Impact of Surgeon and Hospital Volume on the Safety of Robot-Assisted Radical Prostatectomy: A Multi-Institutional Study Based on a National Database |
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