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Predictors of trainees’ proficiency during the learning curve of robot-assisted radical prostatectomy at high- -volume institutions: results from a multicentric series

INTRODUCTION: The aim of this series was to evaluate predictors of Proficiency score (PS) achievement on a multicentric series of robot-assisted radical prostatectomies (RARP) performed by trainee surgeons with two different surgical techniques at four tertiary-care centers. MATERIAL AND METHODS: Fo...

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Autores principales: Anceschi, Umberto, Morelli, Michele, Flammia, Rocco Simone, Brassetti, Aldo, Dell’Oglio, Paolo, Galfano, Antonio, Tappero, Stefano, Vecchio, Enrico, Martiriggiano, Marco, Luciani, Lorenzo Giuseppe, Sperduti, Isabella, Albisinni, Simone, Tuderti, Gabriele, Prata, Francesco, Ferriero, Maria Consiglia, Bove, Alfredo Maria, Mastroianni, Riccardo, Spadaro, Giuseppe, Russo, Andrea, Mattevi, Daniele, Tufano, Antonio, Leonardo, Costantino, Lombardo, Riccardo, De Nunzio, Cosimo, Cai, Tommaso, Quackels, Thierry, Bocciardi, Aldo Massimo, Simone, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Polish Urological Association 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10091888/
https://www.ncbi.nlm.nih.gov/pubmed/37064261
http://dx.doi.org/10.5173/ceju.2023.260
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author Anceschi, Umberto
Morelli, Michele
Flammia, Rocco Simone
Brassetti, Aldo
Dell’Oglio, Paolo
Galfano, Antonio
Tappero, Stefano
Vecchio, Enrico
Martiriggiano, Marco
Luciani, Lorenzo Giuseppe
Sperduti, Isabella
Albisinni, Simone
Tuderti, Gabriele
Prata, Francesco
Ferriero, Maria Consiglia
Bove, Alfredo Maria
Mastroianni, Riccardo
Spadaro, Giuseppe
Russo, Andrea
Mattevi, Daniele
Tufano, Antonio
Leonardo, Costantino
Lombardo, Riccardo
De Nunzio, Cosimo
Cai, Tommaso
Quackels, Thierry
Bocciardi, Aldo Massimo
Simone, Giuseppe
author_facet Anceschi, Umberto
Morelli, Michele
Flammia, Rocco Simone
Brassetti, Aldo
Dell’Oglio, Paolo
Galfano, Antonio
Tappero, Stefano
Vecchio, Enrico
Martiriggiano, Marco
Luciani, Lorenzo Giuseppe
Sperduti, Isabella
Albisinni, Simone
Tuderti, Gabriele
Prata, Francesco
Ferriero, Maria Consiglia
Bove, Alfredo Maria
Mastroianni, Riccardo
Spadaro, Giuseppe
Russo, Andrea
Mattevi, Daniele
Tufano, Antonio
Leonardo, Costantino
Lombardo, Riccardo
De Nunzio, Cosimo
Cai, Tommaso
Quackels, Thierry
Bocciardi, Aldo Massimo
Simone, Giuseppe
author_sort Anceschi, Umberto
collection PubMed
description INTRODUCTION: The aim of this series was to evaluate predictors of Proficiency score (PS) achievement on a multicentric series of robot-assisted radical prostatectomies (RARP) performed by trainee surgeons with two different surgical techniques at four tertiary-care centers. MATERIAL AND METHODS: Four institutional datasets were merged and queried for RARPs performed by surgeons during their learning curve (LC) between 2010 and 2020 using two different approaches (Group A, Retzius-sparing RARP, n = 164; Group B, standard anterograde RARP, n = 79). Logistic regression analysis was performed to identify predictors of PS achievement for the overall trainee cohort. For all analyses, a two-sided p <0.05 was considered significant. RESULTS: Group B showed significantly increased median operative time, positive surgical margins (PSM) status, increased number of nerve-sparing procedures, shorter LC time (each p <0.04). PS, continence status, potency, biochemical recurrence and 1-year trifecta rates were comparable between groups (each p >0.3). On multivariable analysis, time from LC starting ≥12 months (OR = 2.79; 95%IC [1.15–6.76]; p = 0.02) and a nerve-sparing intent (OR = 3.18; 95%IC [1.15–8.77]; p = 0.02) were independent predictors of PS score achievement (Table 3). CONCLUSIONS: Higher PS rates for RARP trainees may be expected after 12 months from LC beginning. Short-term training courses are unlikely to confer proper surgical training, while long-term structured training programs seem to be beneficial on perioperative outcomes.
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spelling pubmed-100918882023-04-13 Predictors of trainees’ proficiency during the learning curve of robot-assisted radical prostatectomy at high- -volume institutions: results from a multicentric series Anceschi, Umberto Morelli, Michele Flammia, Rocco Simone Brassetti, Aldo Dell’Oglio, Paolo Galfano, Antonio Tappero, Stefano Vecchio, Enrico Martiriggiano, Marco Luciani, Lorenzo Giuseppe Sperduti, Isabella Albisinni, Simone Tuderti, Gabriele Prata, Francesco Ferriero, Maria Consiglia Bove, Alfredo Maria Mastroianni, Riccardo Spadaro, Giuseppe Russo, Andrea Mattevi, Daniele Tufano, Antonio Leonardo, Costantino Lombardo, Riccardo De Nunzio, Cosimo Cai, Tommaso Quackels, Thierry Bocciardi, Aldo Massimo Simone, Giuseppe Cent European J Urol Original Paper INTRODUCTION: The aim of this series was to evaluate predictors of Proficiency score (PS) achievement on a multicentric series of robot-assisted radical prostatectomies (RARP) performed by trainee surgeons with two different surgical techniques at four tertiary-care centers. MATERIAL AND METHODS: Four institutional datasets were merged and queried for RARPs performed by surgeons during their learning curve (LC) between 2010 and 2020 using two different approaches (Group A, Retzius-sparing RARP, n = 164; Group B, standard anterograde RARP, n = 79). Logistic regression analysis was performed to identify predictors of PS achievement for the overall trainee cohort. For all analyses, a two-sided p <0.05 was considered significant. RESULTS: Group B showed significantly increased median operative time, positive surgical margins (PSM) status, increased number of nerve-sparing procedures, shorter LC time (each p <0.04). PS, continence status, potency, biochemical recurrence and 1-year trifecta rates were comparable between groups (each p >0.3). On multivariable analysis, time from LC starting ≥12 months (OR = 2.79; 95%IC [1.15–6.76]; p = 0.02) and a nerve-sparing intent (OR = 3.18; 95%IC [1.15–8.77]; p = 0.02) were independent predictors of PS score achievement (Table 3). CONCLUSIONS: Higher PS rates for RARP trainees may be expected after 12 months from LC beginning. Short-term training courses are unlikely to confer proper surgical training, while long-term structured training programs seem to be beneficial on perioperative outcomes. Polish Urological Association 2023-03-03 2023 /pmc/articles/PMC10091888/ /pubmed/37064261 http://dx.doi.org/10.5173/ceju.2023.260 Text en Copyright by Polish Urological Association https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Original Paper
Anceschi, Umberto
Morelli, Michele
Flammia, Rocco Simone
Brassetti, Aldo
Dell’Oglio, Paolo
Galfano, Antonio
Tappero, Stefano
Vecchio, Enrico
Martiriggiano, Marco
Luciani, Lorenzo Giuseppe
Sperduti, Isabella
Albisinni, Simone
Tuderti, Gabriele
Prata, Francesco
Ferriero, Maria Consiglia
Bove, Alfredo Maria
Mastroianni, Riccardo
Spadaro, Giuseppe
Russo, Andrea
Mattevi, Daniele
Tufano, Antonio
Leonardo, Costantino
Lombardo, Riccardo
De Nunzio, Cosimo
Cai, Tommaso
Quackels, Thierry
Bocciardi, Aldo Massimo
Simone, Giuseppe
Predictors of trainees’ proficiency during the learning curve of robot-assisted radical prostatectomy at high- -volume institutions: results from a multicentric series
title Predictors of trainees’ proficiency during the learning curve of robot-assisted radical prostatectomy at high- -volume institutions: results from a multicentric series
title_full Predictors of trainees’ proficiency during the learning curve of robot-assisted radical prostatectomy at high- -volume institutions: results from a multicentric series
title_fullStr Predictors of trainees’ proficiency during the learning curve of robot-assisted radical prostatectomy at high- -volume institutions: results from a multicentric series
title_full_unstemmed Predictors of trainees’ proficiency during the learning curve of robot-assisted radical prostatectomy at high- -volume institutions: results from a multicentric series
title_short Predictors of trainees’ proficiency during the learning curve of robot-assisted radical prostatectomy at high- -volume institutions: results from a multicentric series
title_sort predictors of trainees’ proficiency during the learning curve of robot-assisted radical prostatectomy at high- -volume institutions: results from a multicentric series
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10091888/
https://www.ncbi.nlm.nih.gov/pubmed/37064261
http://dx.doi.org/10.5173/ceju.2023.260
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