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 Citations (Scopus)

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

Fingerprint

Prostatectomy
Length of Stay
Pathologic Constriction
Surgeons
Neoplasms
Therapeutics
Medicare

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

The effect of minimally invasive and open radical prostatectomy surgeon volume. / Choi, Wesley W.; Gu, Xiangmei; Lipsitz, Stuart R.; D'Amico, Anthony V.; Williams, Stephen; Hu, Jim C.

In: Urologic Oncology: Seminars and Original Investigations, Vol. 30, No. 5, 09.2012, p. 569-576.

Research output: Contribution to journalArticle

Choi, Wesley W. ; Gu, Xiangmei ; Lipsitz, Stuart R. ; D'Amico, Anthony V. ; Williams, Stephen ; Hu, Jim C. / The effect of minimally invasive and open radical prostatectomy surgeon volume. In: Urologic Oncology: Seminars and Original Investigations. 2012 ; Vol. 30, No. 5. pp. 569-576.
@article{4704232983034ee8b85321125695fdbd,
title = "The effect of minimally invasive and open radical prostatectomy surgeon volume",
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.",
keywords = "Radical prostatectomy, Robotic surgery, Surgeon volume, Surgical outcomes",
author = "Choi, {Wesley W.} and Xiangmei Gu and Lipsitz, {Stuart R.} and D'Amico, {Anthony V.} and Stephen Williams and Hu, {Jim C.}",
year = "2012",
month = "9",
doi = "10.1016/j.urolonc.2010.06.009",
language = "English (US)",
volume = "30",
pages = "569--576",
journal = "Urologic Oncology",
issn = "1078-1439",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - The effect of minimally invasive and open radical prostatectomy surgeon volume

AU - Choi, Wesley W.

AU - Gu, Xiangmei

AU - Lipsitz, Stuart R.

AU - D'Amico, Anthony V.

AU - Williams, Stephen

AU - Hu, Jim C.

PY - 2012/9

Y1 - 2012/9

N2 - 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.

AB - 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.

KW - Radical prostatectomy

KW - Robotic surgery

KW - Surgeon volume

KW - Surgical outcomes

UR - http://www.scopus.com/inward/record.url?scp=84866753228&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84866753228&partnerID=8YFLogxK

U2 - 10.1016/j.urolonc.2010.06.009

DO - 10.1016/j.urolonc.2010.06.009

M3 - Article

VL - 30

SP - 569

EP - 576

JO - Urologic Oncology

JF - Urologic Oncology

SN - 1078-1439

IS - 5

ER -