Impact of urology resident involvement on intraoperative, long-term oncologic and functional outcomes of robotic assisted laparoscopic radical prostatectomy.

To evaluate the impact of resident involvement in robot-assisted laparoscopic prostatectomy (RALP) on oncologic, functional, and intraoperative outcomes, both short and long term.

We queried our prospectively maintained database of prostate cancer patients who underwent robotic-assisted laparoscopic prostatectomy from November 20, 2007 to December 27, 2016.

We analyzed cases performed by one surgeon on a specific day of the week when the morning case involves at least one resident (R) and the afternoon case involves the attending physician only (NR). We compared R vs. NR on a number of clinical, peri-operative and oncological outcomes.

A total of 230 NR and 230 R cases met inclusion criteria and were included in the analysis. Over one third (36.7%) of the NR group was Gleason 4+3 (Grade Group 3) or higher, relative to 25.9% of the R group, p = 0.015. Median operative time (OT) was significantly longer for R vs. NR (200 min vs 156 min, p <0.001) as was robotic time (161 min vs 119 min, p <0.001). No significant differences were noted for any other measure. Median follow-up for oncological outcomes was 30 and 33.5 months for NR and R, respectively (p=0.3). Median OT and median estimated blood loss (EBL) were both significantly greater in later years relative to the earlier years for R (2012-2016 vs. 2007-2011; p< 0.001 for OT; p = 0.041 for median EBL) but not for NR.

Neither safety nor quality is diminished by resident involvement in RALP.

Urology. 2019 Jun 19 [Epub ahead of print]

Jacob Baber, Ilene Staff, Tara McLaughlin, Joseph Tortora, Alison Champagne, Akshay Gangakhedkar, Kevin Pinto, Joseph Wagner

Urology Division, Hartford Healthcare Medical Group, Hartford Hospital, Hartford, CT 06106, USA. Electronic address: ., Hartford Hospital Research Program, Hartford Hospital, Hartford, CT 06106, USA. Electronic address: ., Urology Division, Hartford Healthcare Medical Group, Hartford Hospital, Hartford, CT 06106, USA. Electronic address: ., Hartford Hospital Research Program, Hartford Hospital, Hartford, CT 06106, USA. Electronic address: ., Hartford Hospital Research Program, Hartford Hospital, Hartford, CT 06106, USA. Electronic address: ., Urology Division, Hartford Healthcare Medical Group, Hartford Hospital, Hartford, CT 06106, USA. Electronic address: ., Urology Division, Hartford Healthcare Medical Group, Hartford Hospital, Hartford, CT 06106, USA. Electronic address: ., Urology Division, Hartford Healthcare Medical Group, Hartford Hospital, Hartford, CT 06106, USA. Electronic address: .

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