Single-port robot-assisted perineal radical prostatectomy with the da Vinci XI system: initial experience and learning curve using the cumulative sum method

Abstract Background To evaluate the early functional and oncological outcomes of single-port robot-assisted perineal radical prostatectomy (sp-pRARP) using the da Vinci XI system and analyze its learning curve using the cumulative sum (CUSUM) method. Methods The clinical data of 50 patients who underwent sp-pRARP for localized prostate cancer between May 2020 and May 2022 in our center by a single surgeon were analyzed retrospectively. Demographic information, preoperative and postoperative variables, complications, early functional and oncological outcomes of patients were recorded. The CUSUM method was used to illustrate the learning curve based on operation time. Results All surgeries were completed without conversion. The median (interquartile range, IQR) operation time was 205.0 (82.5) min, whereas the median (IQR) docking time was 30.0 (15.0) min and the console time was 120.0 (80.5) min. The median (IQR) estimated blood loss (EBL) was 50.0 (137.5) mL. Positive surgical margins were detected in five patients (10.0%). The continence rate was 40.9%, 63.6%, 88.4%, and 97.7% at the 1, 3, 6, and 12 months after surgery. According to the CUSUM plot, the inflection points of the learning curve were 20 cases, splitting the case series into “early phase” and “late phase.” In “late phase” cases, there was less time spent on each step of the operation and less EBL. Conclusions Sp-pRARP using the da Vinci XI system was verified to be a feasible and reliable surgical approach. According to the CUSUM plot, 20 cases was considered the turning point for surgeons to master the novel technique.

Авторы
Yu Chenhao1 , Xu Li1 , Ye Liyin1 , Zheng Qiming1 , Hu Haiyi1 , Ni Kangxin1 , Zhou Chenghao1 , Xue Dingwei1 , Cheng Sheng1 , Wang Hui1 , Pak R.W. 2 , Li Gonghui1
Издательство
BioMed Central
Номер выпуска
1
Язык
Английский
Страницы
46
Статус
Опубликовано
Том
21
Год
2023
Организации
  • 1 Sir Run Run Shaw Hospital, Zhejiang University School of Medicine
  • 2 Department of Urology
Ключевые слова
prostate cancer; radical prostatectomy; perineal prostatectomy; Single port; learning curve; surgical oncology
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Другие записи

Лункин Р.Н., Гу Хо Ом, Дегтерев Д.А., Клемешев А.П., Кузнецова Т.Ю., Федоров Г.М.
Вестник Санкт-Петербургского университета. Международные отношения. Санкт-Петербургский государственный университет. Том 16. 2023. С. 422-444