Background
Methods
Surgeon characteristics and initial steps
Laparoscopic operations | Number of operations | |
---|---|---|
Surgeon 1 | Surgeon 2 | |
Varicocele ligation | 82 | 19 |
Pelvic staging lymph node dissection | 25 | 4 |
Modified retroperitoneal lymph node dissection | 3 | |
Tumor nephrectomy | 1 | |
Simple nephrectomy | 12 | |
Nehproureterectomy | 4 | |
Pyeloplasty | 13 | |
Cyst decortication | 5 | |
Adhesiolysis | 13 | |
Lymphocele fenestration | 19 | 2 |
Patient characteristics
number of patients | 120 |
---|---|
median age in years (range) | 65 (4.1 – 76) |
median PSA in ng/mL (range) | 8.68 (1.1 – 29.9) |
median prostate volume in mL (range) | 30.9 (9 – 87) |
median Gleason score (range) | 6 (3 – 10) |
Oncological and functional follow-up
Technique
Statistical analysis of the learning curve
Results
Peri-operative data
Postoperative management
Intra-operative complications
Early post-operative complications
Histopathological results
Tumour stage | |
---|---|
pT2 (%)
|
66 (55)
|
pT2a (%) | 21 (17.5) |
pT2b (%) | 3 (2.5) |
pT2c (%) | 42 (35) |
pT3 (%)
|
54 (45)
|
pT3a (%) | 39 (32.5) |
pT3b (%) | 15 (12.5) |
Lymph node status | |
PNx (%) | 94 (78.3) |
pN0 (%) | 22 (18.3) |
pN 1–2 (%) | 4 (3.3) |
Gleason score | |
<7 (%) | 70 (58.3) |
≥7 (%) | 50 (41.7) |
Surgical margin status | |
R0 (%) | 91 (75.8) |
R1 (%) | 29 (24.2) |
R1 among pT2 (%)
|
4 (6.1)
|
R1 among pT2a (%) | 1 (4.7) |
R1 among pT2b (%) | 0 |
R1 among pT2c (%) | 3 (7.1) |
R1 among pT3 (%)
|
25 (46)
|
R1 among pT3a (%) | 20 (51) |
R1 among pT3b (%) | 5 (33.3) |
Oncological follow-up
Functional follow – up
Analysis of the learning curve
Comparison of 3 phases
Phase 1 | Phase 2 | Phase 3 | p | S1 | S2 | p | |
---|---|---|---|---|---|---|---|
no. of operations | 9 | 16 | 95 | 70 | 50 | ||
median operation time in minutes (range) | 190 (160–235) | 234 (155–350) | 195 (110–415) | 0.054 | 180 (110–350) | 227 (158–415) |
< 0.001
|
median catheterisation time in days (range) | 6 (6-6) | 6 (6-6) | 6 (6–45) | 0.066 | 6.0 (6–45) | 6.0 (6–40) | 0.285 |
no. of intraoperative complications | 0 | 0 | 6 | 0.746 | 1 | 5 | 0.081 |
no. of postoperative complications | 1 | 0 | 7 | 0.372 | 5 | 3 | 1.000 |
no. of positive surgical margins (%) | 2 (22.2) | 3 (20) | 24 (25.3) | 0.924 | 16 (22.8) | 13 (26) | 1.000 |