Does training of fellows affect peri‐operative outcomes of robot‐assisted partial nephrectomy?

Khene, Z.; Peyronnet, B.; Bosquet, E.; Pradère, Benjamin; Robert, Corentin; Fardoun, T.; Kammerer‐Jacquet, Solène‐Florence; Verhoest, G.; Rioux‐Leclercq, Nathalie; Mathiéu, Romain; Bensalah, Karim

doi:10.1111/bju.13901

Cited by 16 publications

(9 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Table 5 summarizes PSMs rates stratified according to the investigated surgical-related factors ( Table 5). Surgical experience did not influence PSMs rate in a single-surgeon LPN series [7] as well as no differences were observed among expert surgeons and fellows in a single-center RAPN series [33]. Conversely, hospital volume impacts significantly on PSM rate as reported by National Cancer Database [37].…”

Section: Resultsmentioning

confidence: 91%

Positive Surgical Margins After Partial Nephrectomy: A Systematic Review and Meta-Analysis of Comparative Studies

Ficarra

Crestani

Inferrera

et al. 2018

KCA

View full text Add to dashboard Cite

Objective: We performed an update of previous reviews of the literature to provide an overview on incidence, predictive factors, management and prognosis of positive surgical margins (PSMs) after partial nephrectomy (PN) including recent surgical series and studies comparing different approaches and techniques. Material and methods: A literature search was performed from January 2013 to January 2018 using the Medline database. The search strategy included a free-text protocol using the term "nephron-sparing surgery" OR "partial nephrectomy" AND "positive surgical margins" across the title and abstract fields of the records. From each selected study, we extracted the following data: number of analyzed patients, study design, approach and surgical technique used, PSMs rate, pathological features, type of PSMs treatment, mean (median) follow-up duration and final patient status. Meta-analysis was conducted using Review Manager software v. 5.2 (Cochrane Collaboration, Oxford, UK). Results: We selected a total of 36 (48%) studies. All studies were retrospective and the best statistical method used for comparison was the matched-pair analysis (level 4). Overall, 45,786 patients treated with PN were included in the selected studies. PSMs were reported in a total of 3,093 (6.7%) patients. The mean estimated PSMs rate was 7%, 5% and 4.3% in patients who underwent robot-assisted PN (RAPN), laparoscopic PN (LPN) and open PN (OPN), respectively. Comparative studies showed a significant advantage in favor of OPN compared with minimally invasive approach, while RAPN showed more favourable PSMs risk compared with LPN (odds ratio 3.02, 95% confidence intervals 2.05-4.45). No differences were detected stratifying data according to other surgical or tumor-related factors. Tumor size, nuclear grading and pT3a stage represent the most important predictors of PSMs. In 6,809 patients, follow-up data were available. Only 101 (1.4%) local recurrences and 88 (1.3%) distant recurrences were observed both in PSMs and negative surgical margins subgroups. PSMs were associated with a significant increased risk of local recurrence with a significant impact on local recurrence-free survival and metastasis-free survival. However, a significant impact on cancer-specific and overall survival could not be demonstrated.

show abstract

Section: Resultsmentioning

confidence: 91%

Positive Surgical Margins After Partial Nephrectomy: A Systematic Review and Meta-Analysis of Comparative Studies

Ficarra

Crestani

Inferrera

et al. 2018

KCA

View full text Add to dashboard Cite

show abstract

“…A possible explanation could be the academic setting of our present study with low‐volume surgeons being mostly fellows. Junior surgeons with a lower case volume were usually supervised by senior surgeons to ensure proper teaching and patient's safety , which may have hidden or tempered the influence of SV on perioperative outcomes in the present dataset. In a recent publication, it seems that training fellows to perform RAPN is associated with longer operating time and WIT but does not seem to compromise other perioperative outcomes .…”

Section: Discussionmentioning

confidence: 99%

Impact of hospital volume and surgeon volume on robot‐assisted partial nephrectomy outcomes: a multicentre study

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…Numerous confounding variables across institutions such as the presence of consistent teams, specialized services, fellows, residents, and medical students can drastically change both surgical cost and surgical time. 15 , 27 Time allocated to dynamic education or specialized teams in the OR is not recorded in hospital systems but should be integrated to accurately evaluate and understand operating time and costs. Moreover, hospital tracking of additionally needed instruments and problems with sterilization or case delays was not available to be studied.…”

Section: Discussionmentioning

confidence: 99%

The use of preoperative planning to decrease costs and increase efficiency in the OR

Sheth¹,

Lavin²,

Martinez³

et al. 2022

JSES International

View full text Add to dashboard Cite

Does training of fellows affect peri‐operative outcomes of robot‐assisted partial nephrectomy?

Abstract: Training fellows to perform RAPN is associated with longer operating time and WIT but does not appear to compromise other peri-operative outcomes.

Cited by 16 publications

References 37 publications

Positive Surgical Margins After Partial Nephrectomy: A Systematic Review and Meta-Analysis of Comparative Studies

Positive Surgical Margins After Partial Nephrectomy: A Systematic Review and Meta-Analysis of Comparative Studies

Impact of hospital volume and surgeon volume on robot‐assisted partial nephrectomy outcomes: a multicentre study

The use of preoperative planning to decrease costs and increase efficiency in the OR

Contact Info

Product

Resources

About