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Resident involvement and experience do not affect perioperative complications following robotic prostatectomy

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Abstract

Purpose

Most urologic training programs use robotic prostatectomy (RP) as an introduction to teach residents appropriate robotic technique. However, concerns may exist regarding differences in RP outcomes with resident involvement. Our objective was therefore to evaluate whether resident involvement affects complications, operative time, or length of stay (LOS) following RP.

Methods

Using the National Surgical Quality Improvement Program database (2005–2011), we identified patients who underwent RP, stratified them by resident presence or absence during surgery, and compared hospital LOS, operative time, and postoperative complications using bivariable and multivariable analyses. A secondary analysis comparing outcomes of interest across postgraduate year (PGY) levels was also performed.

Results

A total of 5,087 patients who underwent RPs were identified, in which residents participated in 56 %, during the study period. After controlling for potential confounders, resident present and absent groups were similar in 30-day mortality (0.0 vs. 0.2 %, p = 0.08), serious morbidity (1.8 vs. 2.1 %, p = 0.33), and overall morbidity (5.1 vs. 5.4 %, p = 0.70). While resident involvement did not affect LOS, operative time was longer when residents were present (median 208 vs. 183 min, p < 0.001). Similar findings were noted when assessing individual PGY levels.

Conclusions

Regardless of PGY level, resident involvement in RPs appears safe and does not appear to affect postoperative complications or LOS. While resident involvement in RPs does result in longer operative times, this is necessary for the learning process.

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Acknowledgments

The American College of Surgeons National Surgical Quality Improvement Program and the hospitals participating in the ACS NSQIP are the source of the data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors. The project described was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grants KL2TR001109 and UL1TR001111; and the University Cancer Research Fund.

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Authors and Affiliations

  1. University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Daniel T. McMillan

  2. Public Health Leadership Program, Gillings School of Global Public Health, Chapel Hill, NC, USA

    Daniel T. McMillan & Anthony J. Viera

  3. Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Anthony J. Viera

  4. Department of Urology, University of North Carolina at Chapel Hill, 170 Manning Drive, 2113 Physicians Office Building, CB#7235, Chapel Hill, NC, 27599-7235, USA

    Jonathan Matthews, Mathew C. Raynor, Michael E. Woods, Raj S. Pruthi, Eric M. Wallen, Matthew E. Nielsen & Angela B. Smith

  5. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Matthew E. Nielsen

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  1. Daniel T. McMillan
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  2. Anthony J. Viera
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Correspondence to Angela B. Smith.

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McMillan, D.T., Viera, A.J., Matthews, J. et al. Resident involvement and experience do not affect perioperative complications following robotic prostatectomy. World J Urol 33, 793–799 (2015). https://doi.org/10.1007/s00345-014-1356-8

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  • DOI: https://doi.org/10.1007/s00345-014-1356-8

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