Resident involvement and experience do not affect perioperative complications following robotic prostatectomy.

Published

Journal Article

PURPOSE:Most urologic training programs use robotic prostatectomy (RP) as an introduction to teach residents appropriate robotic technique. However, concerns may exist regarding differences in RP outcomes with resident involvement. Our objective was therefore to evaluate whether resident involvement affects complications, operative time, or length of stay (LOS) following RP. METHODS:Using the National Surgical Quality Improvement Program database (2005-2011), we identified patients who underwent RP, stratified them by resident presence or absence during surgery, and compared hospital LOS, operative time, and postoperative complications using bivariable and multivariable analyses. A secondary analysis comparing outcomes of interest across postgraduate year (PGY) levels was also performed. RESULTS:A total of 5,087 patients who underwent RPs were identified, in which residents participated in 56%, during the study period. After controlling for potential confounders, resident present and absent groups were similar in 30-day mortality (0.0 vs. 0.2%, p = 0.08), serious morbidity (1.8 vs. 2.1%, p = 0.33), and overall morbidity (5.1 vs. 5.4%, p = 0.70). While resident involvement did not affect LOS, operative time was longer when residents were present (median 208 vs. 183 min, p < 0.001). Similar findings were noted when assessing individual PGY levels. CONCLUSIONS:Regardless of PGY level, resident involvement in RPs appears safe and does not appear to affect postoperative complications or LOS. While resident involvement in RPs does result in longer operative times, this is necessary for the learning process.

Full Text

Duke Authors

Cited Authors

  • McMillan, DT; Viera, AJ; Matthews, J; Raynor, MC; Woods, ME; Pruthi, RS; Wallen, EM; Nielsen, ME; Smith, AB

Published Date

  • June 2015

Published In

Volume / Issue

  • 33 / 6

Start / End Page

  • 793 - 799

PubMed ID

  • 24985554

Pubmed Central ID

  • 24985554

Electronic International Standard Serial Number (EISSN)

  • 1433-8726

International Standard Serial Number (ISSN)

  • 0724-4983

Digital Object Identifier (DOI)

  • 10.1007/s00345-014-1356-8

Language

  • eng