1127 MAJOR COMPLICATIONS OF ROBOT-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY SIGNIFICANTLY DECREASE AFTER 100 CASES

Abstract

You have accessJournal of UrologyProstate Cancer: Localized V1 Apr 20121127 MAJOR COMPLICATIONS OF ROBOT-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY SIGNIFICANTLY DECREASE AFTER 100 CASES Michael Lasser, Sammy Elsamra, Thavaseelan Simone, Renzulli Joseph, Haleblian George, and Pareek Gyan Michael LasserMichael Lasser Bronx, NY More articles by this author , Sammy ElsamraSammy Elsamra Providence, RI More articles by this author , Thavaseelan SimoneThavaseelan Simone Providence, RI More articles by this author , Renzulli JosephRenzulli Joseph Providence, RI More articles by this author , Haleblian GeorgeHaleblian George Providence, RI More articles by this author , and Pareek GyanPareek Gyan Providence, RI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1236AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Previously we reported an overall complication rate for Robot-Assisted Laparoscopic Radical Prostatectomy (RALRP) of 16% with a major complication rate of 3.1%. As our case volume continues to grow we sought to define a point at which a consistent drop in major complications was achieved. METHODS A total of 476 patients with a mean age of 60.2 ± 0.3 years were evaluated (11/2006 to 1/2010). Data was assimilated through an IRB approved blinded prospective database by an independent third party committee. Data was collected prospectively both at the time of surgery as well as throughout the initial 30 days postoperatively. The Modified Clavien system was utilized to grade complications with grade I and II representing minor and grade III, IV, and V major complications. Our initial experience and that of our most recent were compared. Age, BMI, ASA, Gleason grade, PSA, prostate volume, and complications were compared. RESULTS The first and last 100 cases were found to have similar age (p=0.27), BMI (p=0.11), ASA (p=0.09), and Gleason grade (p=0.28). The last 100 cases were found to have a greater prostate volume and PSA (p<0.05). The Major and Overall complication rates for the first and last 100 cases were 7% and 19% vs. 1% and 19%, respectively. The major complication rates were significantly different (p=0.019). When the major complications between each of the 100 patient quintiles were compared it was found that the first (7%) and second (2%) were significantly different (p<0.05). The subsequent quintiles exhibited no significant change in major complications (Table 1). CONCLUSIONS As a surgeon progresses through the learning curve there is a stable overall complication rate with a drop in major complications. After the first 100 cases a significantly lower rate of major complications can be expected. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e456-e457 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Lasser Bronx, NY More articles by this author Sammy Elsamra Providence, RI More articles by this author Thavaseelan Simone Providence, RI More articles by this author Renzulli Joseph Providence, RI More articles by this author Haleblian George Providence, RI More articles by this author Pareek Gyan Providence, RI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...