Analysis of learning curve for robot-assisted laparoscopic radical prostatectomy: a single operator’s initial experience in 65 cases
10.3969/j.issn.1009-8291.2024.03.005
- VernacularTitle:单一术者65例机器人辅助腹腔镜下前列腺癌根治术的学习曲线分析
- Author:
Ruihang ZHANG
1
;
Jianwen HUANG
1
;
Ying WANG
1
;
Xinru ZHANG
1
;
Lujie SONG
1
;
Qiang FU
1
;
Yinglong SA
1
Author Information
1. Department of Urology, Medical School of Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
- Publication Type:Journal Article
- Keywords:
prostate cancer;
robot-assisted surgery;
laparoscopic radical prostatectomy;
learning curve;
robot-assisted laparoscopic radical prostatectomy
- From:
Journal of Modern Urology
2024;29(3):219-223
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To explore the learning curve of single-surgeon robot-assisted laparoscopic radical prostatectomy (RARP), which provides a reference for physicians who intend to carry out RARP. 【Methods】 The clinical data of 65 prostate cancer patients who underwent RARP in our hospital during Sep.2022 and Dec.2023 were retrospectively analyzed.The patients’ median age was 67.5(58.1-82.4) years, median total prostate-specific antigen (PSA) was 15.6 (6.7-98.4) ng/mL, median body mass index (BMI) was 20.8(17.4-27.3) and preoperative clinical stage of tumor was T2aN0M0-T3bN1M0.The cumulative sum (CUSUM) method was used to fit the learning curves of machine installation time and operation time.According to the inflection points, the learning curves were divided into different learning stages, and the clinical data of patients at different learning stages were compared. 【Results】 The learning curve of RARP was 12 cases.The 65 cases were divided into three stages: 1st-12th cases in the learning stage, 13rd-43rd cases in the mastery stage, and 44th-65th cases in the proficiency stage.With the increase of the number of surgical cases, the median operation time [191(100-360) min vs. 116(83-165) min vs. 90(75-105) min] and median intraoperative blood loss [403(180-900) mL vs. 236(180-305) mL vs. 94(30-200) mL] in the three stages showed a gradual downward trend (P<0.05).The median machines installation time of the learning stage was significantly longer than that in the mastery stage and the proficiency stage [25(21-28) min vs. 12(11-15) min vs. 12(11-14) min] (P<0.05).The positive surgical marginrate (PSM) in the learning stage was significantly higher than that in the mastery stage and proficiency stage (41.7% vs.22.6% vs.22.7%) (P<0.05). 【Conclusion】 For surgeons with rich experience in traditional laparoscopic surgery, the learning curve of RARP is about 12 cases, and after 43 cases, the operation time and intraoperative blood loss can be further reduced.
