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
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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