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

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

doi:10.1159/000460304

Cited by 15 publications

(8 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Budaus et al [ 6 ] reported the relationship between surgeon volume and minimally invasive surgery, including RARP, for the first time. Hirasawa et al [ 7 ] showed that hospital volume is a significant risk factor for perioperative complications. Further, in a study by Xia et al [ 8 ] a higher hospital volume was associated with lower odds of conversion to open surgery, prolonged length of stay, 30-day readmission, and positive surgical margins.…”

Section: Discussionmentioning

confidence: 99%

Association of hospital volume with perioperative and oncological outcomes of robot-assisted laparoscopic radical prostatectomy: a retrospective multicenter cohort study

et al. 2023

View full text Add to dashboard Cite

Background This retrospective multicenter cohort study investigated the association of hospital volume with perioperative and oncological outcomes in patients treated with robot-assisted radical prostatectomy (RARP). Methods We collected the clinical data of patients who underwent RARP at eight institutions in Japan between September 2012 and August 2021. The patients were divided into two groups based on the treatment site—high- and non-high-volume hospitals. We defined a high-volume hospital as one where RARP was performed for more than 100 cases per year. Results After excluding patients who received neoadjuvant therapy, a total of 2753 patients were included in this study. In the high-volume hospital group, console time and estimated blood loss were significantly (p < 0.001) lower than that of the non-high-volume hospital group. However, the continence rate at 3 months after RARP, positive surgical margins, and prostate-specific antigen (PSA)-relapse-free survival showed no significant differences between the two groups. Furthermore, the console time was significantly shorter after 100 cases in the non-high-volume hospital group but not in the high-volume hospital group. Conclusions A higher hospital volume was significantly associated with shorter console time and less estimated blood loss. However, oncological outcomes and early continence recovery appear to be comparable regardless of the hospital volume in Japan.

show abstract

Section: Discussionmentioning

confidence: 99%

Association of hospital volume with perioperative and oncological outcomes of robot-assisted laparoscopic radical prostatectomy: a retrospective multicenter cohort study

et al. 2023

View full text Add to dashboard Cite

show abstract

“…This has also been shown by Schiffmann et al [14] who not only described that patients treated by high-volume surgeons were more likely to undergo RARP rather than ORP but also showed that patients residing in rural areas and those with cT2 and higher were less likely to undergo RARP compared to ORP. Furthermore, another study from Japan showed that there is an increased risk for complications in RARP associated with hospital and surgeon volume [15].…”

Section: Discussionmentioning

confidence: 99%

Influences of Surgical Volume on Perioperative and Oncological Outcomes Following Radical Prostatectomy

et al. 2018

View full text Add to dashboard Cite

Introduction: The purpose of this study was to evaluate whether the number of radical prostatectomies per hospital per year is associated with stage distribution, surgical techniques or quality related outcome in Germany. Materials and Methods: A German Internet-based database was analyzed. Hospitals were categorized according to their yearly radical prostatectomy (RP) volume. Patient’s characteristics, RP techniques, and outcome-related parameters were compared between the different hospital volume categories. Results: A total of 6,447 patients were analyzed. The highest rate of organ-confined disease and the lowest rate of extracapsular invasion have been demonstrated in very low-volume centres (72.6%

show abstract

“…In contrast, with RARP, about 80 to 120 cases are needed to attain a comparable perioperative, oncological, and functional outcomes [22]. Further, with increasing experience in RARP, the perioperative complications declined from 9.8% in low-volume surgeons to 6.7% in intermediate-volume surgeons and to 2.2% in high-volume surgeons [23]. In a retrospective analysis from India, Garg et al showed an inverse stage migration pattern in their RARP practice.…”

Section: Abbreviationsmentioning

confidence: 99%

Outcomes of Robotic Surgery for Low-Volume Surgeons

Panaiyadiyan¹,

Kumar²

2022

SIUJ

View full text Add to dashboard Cite

When the outcomes are equivalent to the open technique, conventional laparoscopy is a preferred surgical approach because of its minimal invasiveness. However, outcomes following laparoscopy depend on the surgeon’s expertise, and there is a significant learning curve to attain efficiency in complex reconstructing laparoscopic procedures. Robotic assistance bridges the gap between open and laparoscopic procedures and allows surgeons with limited laparoscopy experience to offer the benefits of minimally invasive surgery to their patients. While existing data do not show better outcomes with robot assistance compared with laparoscopy for most procedures, these studies are based on data from high-volume surgeons and centers. In reality, a significant number of surgeries are performed by low-volume centers and surgeons, and robotic assistance may enable them to offer benefits of minimally invasive surgery equivalent to those of higher volume centers since robotic assistance is associated with a shorter learning curve than laparoscopy. We review the data on the outcomes of robotic surgery for low-volume surgeons with a focus on centers and surgeons in Asia.

show abstract

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

Cited by 15 publications

References 33 publications

Association of hospital volume with perioperative and oncological outcomes of robot-assisted laparoscopic radical prostatectomy: a retrospective multicenter cohort study

Association of hospital volume with perioperative and oncological outcomes of robot-assisted laparoscopic radical prostatectomy: a retrospective multicenter cohort study

Influences of Surgical Volume on Perioperative and Oncological Outcomes Following Radical Prostatectomy

Outcomes of Robotic Surgery for Low-Volume Surgeons

Contact Info

Product

Resources

About