The effect of minimally invasive and open radical prostatectomy surgeon volume

Wesley W. Choi, Xiangmei Gu, Stuart R. Lipsitz, Anthony V. D'Amico, Stephen Williams, Jim C. Hu

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Objective: To determine the effect of minimally invasive radical prostatectomy (MIRP) surgeon volume on outcomes, and correlate with those of open radical prostatectomy retropubic (ORP). Methods and materials: Observational population-based study of 8,831 men undergoing MIRP and ORP by 1,457 low, medium, and high volume surgeons from SEER-Medicare linked data from 2003 to 2007. After stratifying by surgeon ORP and MIRP volume, the following outcomes were studied: length of stay, transfusions, post-operative 30-day and anastomotic stricture complications, and use of additional cancer therapies. Results: Men undergoing MIRP with high and medium vs. low volume surgeons were less likely to require additional cancer therapies (4.5% and 4.7% vs. 7%, P = 0.020). Similarly, men undergoing ORP with high vs. medium and low volume surgeons were less likely to require additional cancer therapies (5.7% vs. 6.8% and 7.1%, P = 0.044). Men undergoing ORP with high vs. medium and low volume surgeons experienced shorter lengths of stay (2.9 vs. 3.3 and 3.6 days, P <0.001), and fewer transfusions (15.4% vs. 21.3% and 22.7%, P = 0.017), 30-day complications (18.4% vs. 25.6% and 25.7%, P <0.001), and anastomotic strictures (10.1% vs. 15.6% and 16.3%, P = 0.003). However, MIRP surgeon volume did not affect these outcomes. Conclusions: Men undergoing MIRP or ORP with high volume surgeons were less likely to require additional cancer therapies. Additionally, patients of high volume ORP surgeons were more likely to experience shorter hospital stays, fewer transfusions, 30-day complications, and anastomotic strictures, while MIRP surgeon volume did not affect these peri-operative outcomes.

Original languageEnglish (US)
Pages (from-to)569-576
Number of pages8
JournalUrologic Oncology: Seminars and Original Investigations
Volume30
Issue number5
DOIs
StatePublished - Sep 2012
Externally publishedYes

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Keywords

  • Radical prostatectomy
  • Robotic surgery
  • Surgeon volume
  • Surgical outcomes

ASJC Scopus subject areas

  • Oncology
  • Urology

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