Analysis of single port robot-assisted laparoscopic prostatectomy curve of one single surgeon

doi:10.3877/cma.j.issn.1674-3253.2023.01.007

Abstract

Abstract:

Objective

To evaluate the effect of single port robot-assisted laparoscopic prostatectomy (sp-RALP) performed by a single surgeon in different time periods, and explore the learning curve of the surgical method.

Method

A retrospective analysis of the clinical data of 100 prostate cancer patients received sp-RALP by the same surgeon in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January 2020 to December 2020 was conducted. Patients were divided into 5 groups in chronological order: group A (group in stage 1) included cases 1-20, group B (group in stage 2) included cases 21-40, group C (group in stage 3) included cases 41-60, group D (group in stage 4) included cases 61-80 and group E (group in stage 5) included cases 81-100. The operation time, intraoperative bleeding, indwelling time of drainage tube, and postoperative hospital stay among the 5 groups were compared.

Results

With increasing experiences, the operation time and intraoperative blood loss showed a downward trend. The differences among group A and groups C, D, and E were statistically significant and the differences among group B and groups C, D, and E were also statistically significant (P<0.05). groups A and B only exhibited a statistically significant difference in operation time (P<0.05), whereas, there was no statistically significant difference between the pairwise comparisons of groups C, D, and E (P>0.05). There were also no statistically significant differences in the drainage tube indwelling time and postoperative hospital stay among these groups (P>0.05).

Conclusions

The sp-RALP learning curve is relatively steep, and the technique is basically grasped after about 40 cases of surgical experience accumulation. The operation time is significantly shortened, and the amount of bleeding is significantly reduced.

Key words: Robot, Prostate cancer, Single port laparoscopy, Learning curve

Yong Wei, Luming Shen, Chen Zhu, Xiangming Cheng, Yunfei Wei, Lin Yuan, Jian Su, Qingyi Zhu. Analysis of single port robot-assisted laparoscopic prostatectomy curve of one single surgeon[J]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(01): 30-35.

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References 17

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组别	年龄[岁，(±s)]	体质指数BMI[kg/m²，(±s)]	前列腺体积[ml，(±s)]	PSA[ng/ml，M(Q)]
A组	71±9	24.8±2.7	47±18	13.5(33.3)
B组	70±8	23.5±3.0	51±30	15.9(11.4)
C组	70±8	23.4±2.2	46±21	14.3(24.7)
D组	70±8	23.1±2.4	47±16	10.3(52.2)
E组	71±8	22.7±3.2	42±18	14.2(35.4)
统计值	F=0.100	F=1.463	F=1.119	Z=0.512
P值	0.982	0.220	0.352	0.817

组别	年龄[岁，(±s)]	体质指数BMI[kg/m²，(±s)]	前列腺体积[ml，(±s)]	PSA[ng/ml，M(Q)]
A组	71±9	24.8±2.7	47±18	13.5(33.3)
B组	70±8	23.5±3.0	51±30	15.9(11.4)
C组	70±8	23.4±2.2	46±21	14.3(24.7)
D组	70±8	23.1±2.4	47±16	10.3(52.2)
E组	71±8	22.7±3.2	42±18	14.2(35.4)
统计值	F=0.100	F=1.463	F=1.119	Z=0.512
P值	0.982	0.220	0.352	0.817

组别	手术时间[min，(±s)]	机器人操作时间[min，(±s)]	术中出血量[ml，M(Q)]	引流管留置时间(d)	术后住院时间[d，(±s)]
A组	153±34	122±31	48（60）	5.2±2.3	14.9±10.0
B组	145±28	116±27	26（46）	6.5±5.4	12.8±4.4
C组	121±41	95±39	8（5）	6.5±2.4	11.8±3.4
D组	124±27	101±26	9（7）	8.4±6.5	12.1±6.2
E组	111±35	81±34	9（7）	7.1±2.2	11.2±7.5
统计值	F=5.450	F=4.953	Z=4.799	F=1.662	F=0.852
P值	<0.001	<0.001	<0.001	0.165	0.496

组别	手术时间[min，(±s)]	机器人操作时间[min，(±s)]	术中出血量[ml，M(Q)]	引流管留置时间(d)	术后住院时间[d，(±s)]
A组	153±34	122±31	48（60）	5.2±2.3	14.9±10.0
B组	145±28	116±27	26（46）	6.5±5.4	12.8±4.4
C组	121±41	95±39	8（5）	6.5±2.4	11.8±3.4
D组	124±27	101±26	9（7）	8.4±6.5	12.1±6.2
E组	111±35	81±34	9（7）	7.1±2.2	11.2±7.5
统计值	F=5.450	F=4.953	Z=4.799	F=1.662	F=0.852
P值	<0.001	<0.001	<0.001	0.165	0.496

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