MP59-03 MAY ROBOT-ASSISTED PARTIAL NEPHRECTOMY BE TAUGHT TO FELLOWS WITHOUT AFFECTING PERIOPERATIVE OUTCOMES?

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV1 Apr 2017MP59-03 MAY ROBOT-ASSISTED PARTIAL NEPHRECTOMY BE TAUGHT TO FELLOWS WITHOUT AFFECTING PERIOPERATIVE OUTCOMES? Zine-Eddine KHENE, Benoit Peyronnet, Elise Bosquet, Benjamin Pradère, Gregory Verhoest, Romain Mathieu, Solène-Florence Kammerer-Jacquet, Nathalie Rioux-Leclercq, and Karim Bensalah Zine-Eddine KHENEZine-Eddine KHENE More articles by this author , Benoit PeyronnetBenoit Peyronnet More articles by this author , Elise BosquetElise Bosquet More articles by this author , Benjamin PradèreBenjamin Pradère More articles by this author , Gregory VerhoestGregory Verhoest More articles by this author , Romain MathieuRomain Mathieu More articles by this author , Solène-Florence Kammerer-JacquetSolène-Florence Kammerer-Jacquet More articles by this author , Nathalie Rioux-LeclercqNathalie Rioux-Leclercq More articles by this author , and Karim BensalahKarim Bensalah More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1819AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Surgical teaching may potentially influence patient care. A safe, high-quality surgery practice requires dedicated and specialized training commonly acquired during a fellowship. The purpose of this study was to determine whether robot-assisted partial nephrectomy (RAPN) may be taught to fellows without influencing operative outcomes. METHODS We analyzed 276 patients who underwent RAPN for a small renal tumour. We stratified our cohort in two groups according to the involvement or not of a surgeon in training during the procedure: expert surgeon operating alone (expert group) or surgeon in training operating under the supervision of the expert surgeon (fellow group). Patients who underwent RAPN during the early learning curve of the expert surgeon (first 60 NPRA) were excluded. Peri-operative data were compared between the two groups. Linear and logistic regression analyses were performed to assess the impact of fellows involvement on perioperative and postoperative outcomes. RESULTS Fellows were involved in a total of 89 procedures (41 %) and 127 (59 %) of cases were done by the expert surgeon alone. The patients characteristics were comparable in both groups. Operative time (OT) and warm ischemia time (WIT) were longer in the fellow group (188.2 vs. 129.9 min; p < 0.001, and 17.7 vs. 14.8 min; p<0.001, respectively) as was LOS (5 vs. 4.3; p = 0.05). Patients in the fellow group had a higher blood loss (491.8 vs.409.6 ml ; p = 0.01) but this had no impact on the transfusion rate (14 vs. 11%; p =0.43). Positive surgical margin rates were similar between expert and fellow groups (6.9 vs. 5.8%; p = 0.78). The major complications rate was higher in the fellow group (12%) but this difference did not reach statistical significance (p= 0.12). In multivariable analysis, fellow involvement was predictive of increased WIT ([beta]=0.21;p<0.004) and OT ([beta]=0.49;p<0.0001) but was not associated with LOS ([beta]=0.12, p=0.11). CONCLUSIONS Fellows involvement in RAPN is associated with increased OT and WIT. However, it does not adversely affect complication rates or surgical margins. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e781 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Zine-Eddine KHENE More articles by this author Benoit Peyronnet More articles by this author Elise Bosquet More articles by this author Benjamin Pradère More articles by this author Gregory Verhoest More articles by this author Romain Mathieu More articles by this author Solène-Florence Kammerer-Jacquet More articles by this author Nathalie Rioux-Leclercq More articles by this author Karim Bensalah More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...