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Outcomes of Laparoscopic Partial Nephrectomy after Fellowship Training

BACKGROUND AND OBJECTIVES: Experienced surgeons at select high-volume centers have reported favorable outcomes of laparoscopic partial nephrectomy (LPN) in their contemporary experience. However, it is unclear whether recently fellowship-trained surgeons can replicate such outcomes. We evaluated LPN...

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Autores principales: Shah, Satyan K., Matin, Surena F., Singer, Eric A., Eichel, Louis, Kim, Hyung L.
Formato: Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015948/
https://www.ncbi.nlm.nih.gov/pubmed/19660208
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author Shah, Satyan K.
Matin, Surena F.
Singer, Eric A.
Eichel, Louis
Kim, Hyung L.
author_facet Shah, Satyan K.
Matin, Surena F.
Singer, Eric A.
Eichel, Louis
Kim, Hyung L.
author_sort Shah, Satyan K.
collection PubMed
description BACKGROUND AND OBJECTIVES: Experienced surgeons at select high-volume centers have reported favorable outcomes of laparoscopic partial nephrectomy (LPN) in their contemporary experience. However, it is unclear whether recently fellowship-trained surgeons can replicate such outcomes. We evaluated LPNs performed by 3 surgeons in their initial years of independent practice following laparoscopic fellowship training. METHODS: Prospectively maintained databases were queried for LPNs performed during the first 3.5 years of practice. Intraoperative parameters, oncological efficacy, and postoperative complications were analyzed. RESULTS: Of 138 total LPNs (76 left, 62 right), the mean patient age was 57 years, mean tumor size was 2.52cm, and mean depth of invasion was 1.68cm. Mean OR time was 252 minutes, mean warm ischemia time (WIT) was 26 minutes, and mean estimated blood loss (EBL) was 202 mL. Complications occurred in 7 patients (5%), and conversions occurred in 9 patients (7%). Comparison of the first 15 vs. the last 15 cases demonstrated a significant reduction in mean OR time (204 min vs. 253 min, P=0.007), and mean WIT (24 min vs. 32 min, P<0.001). No significant change was demonstrated for tumor size (2.6 cm vs. 2.4 cm, P=0.390) or EBL (226 mL vs. 220 mL, P=0.922). CONCLUSION: Newly fellowship-trained surgeons performing LPN achieve initial outcomes comparable to those reported by highly experienced surgeons. Further experience reduced total operative and warm ischemia times.
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spelling pubmed-30159482011-02-17 Outcomes of Laparoscopic Partial Nephrectomy after Fellowship Training Shah, Satyan K. Matin, Surena F. Singer, Eric A. Eichel, Louis Kim, Hyung L. JSLS Scientific Papers BACKGROUND AND OBJECTIVES: Experienced surgeons at select high-volume centers have reported favorable outcomes of laparoscopic partial nephrectomy (LPN) in their contemporary experience. However, it is unclear whether recently fellowship-trained surgeons can replicate such outcomes. We evaluated LPNs performed by 3 surgeons in their initial years of independent practice following laparoscopic fellowship training. METHODS: Prospectively maintained databases were queried for LPNs performed during the first 3.5 years of practice. Intraoperative parameters, oncological efficacy, and postoperative complications were analyzed. RESULTS: Of 138 total LPNs (76 left, 62 right), the mean patient age was 57 years, mean tumor size was 2.52cm, and mean depth of invasion was 1.68cm. Mean OR time was 252 minutes, mean warm ischemia time (WIT) was 26 minutes, and mean estimated blood loss (EBL) was 202 mL. Complications occurred in 7 patients (5%), and conversions occurred in 9 patients (7%). Comparison of the first 15 vs. the last 15 cases demonstrated a significant reduction in mean OR time (204 min vs. 253 min, P=0.007), and mean WIT (24 min vs. 32 min, P<0.001). No significant change was demonstrated for tumor size (2.6 cm vs. 2.4 cm, P=0.390) or EBL (226 mL vs. 220 mL, P=0.922). CONCLUSION: Newly fellowship-trained surgeons performing LPN achieve initial outcomes comparable to those reported by highly experienced surgeons. Further experience reduced total operative and warm ischemia times. Society of Laparoendoscopic Surgeons 2009 /pmc/articles/PMC3015948/ /pubmed/19660208 Text en © 2009 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Scientific Papers
Shah, Satyan K.
Matin, Surena F.
Singer, Eric A.
Eichel, Louis
Kim, Hyung L.
Outcomes of Laparoscopic Partial Nephrectomy after Fellowship Training
title Outcomes of Laparoscopic Partial Nephrectomy after Fellowship Training
title_full Outcomes of Laparoscopic Partial Nephrectomy after Fellowship Training
title_fullStr Outcomes of Laparoscopic Partial Nephrectomy after Fellowship Training
title_full_unstemmed Outcomes of Laparoscopic Partial Nephrectomy after Fellowship Training
title_short Outcomes of Laparoscopic Partial Nephrectomy after Fellowship Training
title_sort outcomes of laparoscopic partial nephrectomy after fellowship training
topic Scientific Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015948/
https://www.ncbi.nlm.nih.gov/pubmed/19660208
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