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434 The learning curve of minimally invasive partial nephrectomy: The experience of a single surgeon
434
The learning curve of minimally invasive partial nephrectomy: The experience of a single surgeon Eur Urol Suppl 2014;13;e434
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Li H., Chung H-J., Lin A., Chen K-K. Taipei Veterans General Hospital, Dept. of Urology, Taipei City, Taiwan INTRODUCTION & OBJECTIVES: Minimally invasive partial nephrectomy has become the standard of treatment for cT1 renal tumor. We evaluate the learning curve of laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RPN) of a single surgeon. MATERIAL & METHODS: In our prospectively maintained database we identified 175 minimally invasive partial nephrectomies performed from April 2004 through June 2012 by one surgeon (HJ Chung). The patients with open conversion or without pure-LPN or RPN were excluded. Sixty-nine LPNs and 71 RPNs were eligible for analysis and divided into LPN1 (1 – 25), LPN2 (26 – 50), LPN3 (51 – 69), RPN1 (1 – 25), RPN2 (26 – 50), and RPN3 (51 – 71) groups. Perioperative data, operative time, warm ischemia time (WIT), estimated blood loss (EBL), and post-operative length of hospital stay (LOS) were compared within the LPN and RPN groups. The data of most recent LPN and RPN groups were also compared. RESULTS: The overall WIT (39.95 vs. 24.19 minutes), operation time (285.07 vs. 215.39 minutes), and post-operative hospital stay (6.3 vs. 5.5 days) were significantly shorter in RPN group and other parameters were not statistically different in these two groups. In patients who received LPN, the warm ischemia time and operation time improved when compared LPN3 with LPN1 groups. In RPN groups, the pre- and perioperative data didn’t show significant difference. If we compare the latest LPN and RPN groups, the pre- and perioperative data didn’t show significant difference between these two groups either. CONCLUSIONS: The learning curve was obvious in urologist who performs laparoscopic partial nephrectomy. The warm ischemia time, operation time, and post-operative hospital stay were improved as experience increased in LPN. The transition from LPN to RPN is rapid in an experienced laparoscopic surgeon.
The learning curve of minimally invasive partial nephrectomy: The experience of a single surgeon Eur Urol Suppl 2014;13;e434
Print! Print!
Li H., Chung H-J., Lin A., Chen K-K. Taipei Veterans General Hospital, Dept. of Urology, Taipei City, Taiwan INTRODUCTION & OBJECTIVES: Minimally invasive partial nephrectomy has become the standard of treatment for cT1 renal tumor. We evaluate the learning curve of laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RPN) of a single surgeon. MATERIAL & METHODS: In our prospectively maintained database we identified 175 minimally invasive partial nephrectomies performed from April 2004 through June 2012 by one surgeon (HJ Chung). The patients with open conversion or without pure-LPN or RPN were excluded. Sixty-nine LPNs and 71 RPNs were eligible for analysis and divided into LPN1 (1 – 25), LPN2 (26 – 50), LPN3 (51 – 69), RPN1 (1 – 25), RPN2 (26 – 50), and RPN3 (51 – 71) groups. Perioperative data, operative time, warm ischemia time (WIT), estimated blood loss (EBL), and post-operative length of hospital stay (LOS) were compared within the LPN and RPN groups. The data of most recent LPN and RPN groups were also compared. RESULTS: The overall WIT (39.95 vs. 24.19 minutes), operation time (285.07 vs. 215.39 minutes), and post-operative hospital stay (6.3 vs. 5.5 days) were significantly shorter in RPN group and other parameters were not statistically different in these two groups. In patients who received LPN, the warm ischemia time and operation time improved when compared LPN3 with LPN1 groups. In RPN groups, the pre- and perioperative data didn’t show significant difference. If we compare the latest LPN and RPN groups, the pre- and perioperative data didn’t show significant difference between these two groups either. CONCLUSIONS: The learning curve was obvious in urologist who performs laparoscopic partial nephrectomy. The warm ischemia time, operation time, and post-operative hospital stay were improved as experience increased in LPN. The transition from LPN to RPN is rapid in an experienced laparoscopic surgeon.