Association of surgeon and hospital volume with short-term outcomes after robot-assisted radical prostatectomy : Nationwide, population-based study
Autor: | Fredrik Sandin, Eva Johansson, David Robinsson, Göran Ahlgren, Jonas Hugosson, Erik Persson, Stefan Carlsson, Walter Cazzaniga, Pär Stattin, Rebecka Arnsrud Godtman |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Male
medicine.medical_treatment Health Care Providers Biopsy Cancer Treatment Logistic regression Geographical locations Prostate cancer Robotic Surgical Procedures Urologi och njurmedicin Medicine and Health Sciences Blood and Lymphatic System Procedures Medical Personnel Stage (cooking) education.field_of_study Multidisciplinary medicine.diagnostic_test Prostatectomy Prostate Cancer Prostate Diseases Margins of Excision Middle Aged Europe Dissection Professions Treatment Outcome Surgical Oncology Oncology Cohort Medicine Research Article Clinical Oncology medicine.medical_specialty Hospitals Low-Volume Science Urology Population Operative Time Surgical and Invasive Medical Procedures Physicians medicine Humans Urology and Nephrology European Union education Perioperative Period Aged Surgeons Sweden business.industry General surgery Kirurgi Prostatic Neoplasms Cancers and Neoplasms medicine.disease Health Care Genitourinary Tract Tumors People and Places Lymph Node Dissection Lymph Node Excision Population Groupings Surgery Neoplasm Grading Clinical Medicine business Hospitals High-Volume |
Zdroj: | PLoS ONE PLoS ONE, Vol 16, Iss 6, p e0253081 (2021) |
Popis: | Background and objective Few studies have investigated the association between surgical volume and outcome of robot-assisted radical prostatectomy (RARP) in an unselected cohort. We sought to investigate the association between surgical volume with peri-operative and short-term outcomes in a nation-wide, population-based study group. Methods 9,810 RARP’s registered in the National Prostate Cancer Register of Sweden (2015–2018) were included. Associations between outcome and volume were analyzed with multivariable logistic regression including age, PSA-density, number of positive biopsy cores, cT stage, Gleason score, and extent of lymph node dissection. Results Surgeons and hospitals in the highest volume group compared to lowest group had shorter operative time; surgeon (OR 9.20, 95% CI 7.11–11.91), hospital (OR 2.16, 95% CI 1.53–3.06), less blood loss; surgeon (OR 2.58. 95% CI 2.07–3.21) hospital (no difference), more often nerve sparing intention; surgeon (OR 2.89, 95% CI 2.34–3.57), hospital (OR 2.02, 95% CI 1.66–2.44), negative margins; surgeon (OR 1.90, 95% CI 1.54–2.35), hospital (OR 1.28, 95% CI 1.07–1.53). There was wide range in outcome between hospitals and surgeons with similar volume that remained after adjustment. Conclusions High surgeon and hospital volume were associated with better outcomes. The range in outcome was wide in all volume groups, which indicates that factors besides volume are of importance. Registration of surgical performance is essential for quality control and improvement. |
Databáze: | OpenAIRE |
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