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https://observatorio.fm.usp.br/handle/OPI/22535
Title: | Learning Curve for Radical Retropubic Prostatectomy |
Authors: | SAITO, Fernando J. A.; DALL'OGLIO, Marcos F.; EBAID, Gustavo X.; BRUSCHINI, Homero; CHADE, Daher C.; SROUGI, Miguel |
Citation: | INTERNATIONAL BRAZ J UROL, v.37, n.1, p.67-74, 2011 |
Abstract: | Purpose: The learning curve is a period in which the surgical procedure is performed with difficulty and slowness, leading to a higher risk of complications and reduced effectiveness due the surgeon's inexperience. We sought to analyze the residents' learning curve for open radical prostatectomy (RP) in a training program. Materials and Methods: We conducted a prospective study from June 2006 to January 2008 in the academic environment of the University of Sao Paulo. Five residents operated on 184 patients during a four-month rotation in the urologic oncology division, mentored by the same physician assistants. We performed sequential analyses according to the number of surgeries, as follows: <= 10, 11 to 19, 20 to 28, and >= 29. Results: The residents performed an average of 37 RP each. The average PSA was 9.3 ng/mL and clinical stage T1c in 71% of the patients. The pathological stage was pT2 (73%), pT3 (23%), pT4 (4%), and 46% of the patients had a Gleason score 7 or higher. In all surgeries, the average operative time and estimated blood loss was 140 minutes and 488 mL. Overall, 7.2% of patients required blood transfusion, and 23% had positive surgical margins. Conclusion: During the initial RP learning curve, we found a significant reduction in the operative time; blood transfusion during the procedures and positive surgical margin rate were stable in our series. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MCG Artigos e Materiais de Revistas Científicas - HC/ICESP Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - LIM/55 |
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