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

Peyronnet, B.; Tondut, L.; Bernhard, Jean-Christophe; Vaessen, Christophe; Doumerc, N.; Sèbe, Philippe; Pradère, Benjamin; Guillonneau, Bertrand; Khene, Z.; Nouhaud, François-Xavier; Brichart, N.; Seisen, Thomas; Alimi, Q.; Beauval, Jean-Baptiste; Mathiéu, Romain; Rammal, A.; Taille, Alexandre de la; Baumert, H.; Droupy, S.; Bruyère, F.; Rouprêt, Morgan; Méjean, Arnaud; Bensalah, Karim

doi:10.1111/bju.14175

Cited by 56 publications

(43 citation statements)

References 26 publications

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“…There were no significant differences in complications, duration of surgery, blood loss, changes in serum creatinine levels after surgery, or positive surgical margins [73]. The studies suggest that the number of procedures (NSS in general/ robot-assisted NSS) performed in a clinical center (hospital volume) influences outcomes in terms of surgical complications and margins [74,75].…”

Section: Laparoscopic Versus Open Partial Nephrectomymentioning

confidence: 85%

Zalecenia Postępowania Diagnostyczno-Terapeutycznego W Raku Nerkowokomórkowym

et al. 2021

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Section: Laparoscopic Versus Open Partial Nephrectomymentioning

confidence: 85%

Zalecenia Postępowania Diagnostyczno-Terapeutycznego W Raku Nerkowokomórkowym

et al. 2021

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“…Although the trifecta achievement rate increased with surgeon volume, it was not statistically significant in a multivariate analysis adjusting both hospital and surgeon volume. It was finally stated by the authors that hospital volume had a greater impact on perioperative outcomes than surgeon volume (23).…”

Section: Discussionmentioning

confidence: 99%

‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon

Başataç

Akpınar

2020

Int. braz j urol.

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Objective: There is limited data regarding surgeon volume and partial nephrectomy outcomes. The aim of this study is to report trifecta outcomes of robot-assisted partial nephrectomy (RAPN) performed by the low volume surgeon. Materials and Methods: Thirty-nine patients with clinical T1-2 renal tumors who underwent RAPN between 2012 and 2018 were included in this study. Trifecta was defined as negative surgical margins, warm ischemia time ≤20 minutes, and no operative complications. Patient demographics, R.E.N.A.L. nephrometry score, operation time, estimated blood loss, warm ischemia time, length of hospital stay, renal functions, and oncological outcomes were analyzed retrospectively. Complications were graded based on the modified Clavien-Dindo classification system. Results: The median R.E.N.A.L. nephrometry score was 6 (4-10). RAPN was successfully performed in all but one patient. The median operation time was 180 (90-240) minutes. Warm ischemia was performed only by segmental renal artery control in 35 and, by main renal artery control in three patients. The off-clamp technique was used in two patients. The median warm ischemia time was 16 (0-31) minutes. Seven patients had a warm ischemia time of longer than 20 minutes. Three patients had postoperative complications. The surgical margin was positive in one patient. As a result, the trifecta was achieved in 30 of the 39 patients (77%). Conclusion: RAPN is a safe and effective minimally invasive alternative in the treatment of renal masses. The present study suggests that reasonable trifecta rates can be achieved even by low volume surgeons.

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“…An alternative report by another centre identified needing to perform 61-90 cases to reach a trifecta of no significant complications, negative surgical margins and WIT of less than 25 min [9]. Needless to say learning curves can be improved with better training techniques, volume and exposure [10]. WIT was found to decrease to 13 from 20 min, following performing 150 RAPN cases compared to the first 10 cases [11].…”

Section: Introductionmentioning

confidence: 99%

Robot-Assisted Partial Nephrectomy: Evolving Techniques

Quraishi¹,

Latif²,

Thomas³

et al. 2020

Evolving Trends in Kidney Cancer

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Robotic-assisted partial nephrectomy is now embraced in urology as a recommended treatment option for small localised renal tumours. There is an increasing trend towards setting up robotic-assisted services in urological centres across the world. Our aim is to review the available published common robotic-assisted partial nephrectomy techniques. We present our institutions' established step-by-step technique for performing robotic-assisted partial nephrectomy, in order to guide aspiring urologists interested in performing robotic-assisted partial nephrectomies. The importance of pre-operative review of imaging in a multidisciplinary approach is critical. We emphasise certain tips inperforming a safer procedure.

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

Abstract: In this multicentre study HV and SV both greatly influenced RAPN perioperative outcomes, but HV appeared to have a greater impact than SV.

Cited by 56 publications

References 26 publications

Zalecenia Postępowania Diagnostyczno-Terapeutycznego W Raku Nerkowokomórkowym

Zalecenia Postępowania Diagnostyczno-Terapeutycznego W Raku Nerkowokomórkowym

‘Trifecta’ outcomes of robot-assisted partial nephrectomy: Results of the ‘low volume’ surgeon

Robot-Assisted Partial Nephrectomy: Evolving Techniques

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