Scientific Publications Database

Article Title: Long-term patient outcomes from the first year of a robotic surgery program using multi-surgeon implementation
Authors: Montroy, Joshua; Elzayat, Ehab; Morash, Chris; Blew, Brian; Lavallee, Luke T.; Cagiannos, Ilias; Watterson, James; Oake, Jeffrey S.; FungKeeFung, Michael; Thompson, Calvin; Weber, Robert; Breau, Rodney H.
Journal: CUAJ-CANADIAN UROLOGICAL ASSOCIATION JOURNAL Volume 12 Issue 2
Date of Publication:2018
Abstract:
Introduction: There is concern that surgical quality initially declines during the learning phase of robotic surgery. At our institution, we used a multi-surgeon programmatic approach to the introduction of robotic surgery. The purpose of this study was to evaluate outcomes of patients treated during the first year of our program.Methods: This is a historical cohort of all radical prostatectomy patients during a one-year period. Baseline, perioperative, and long-term followup data were prospectively and retrospectively collected. Treatment failure was a composite of any postoperative radiation, androgen-deprivation, or prostate-specific antigen (PSA) >= 0.2.Results: During the study period, 225 radical prostatectomy procedures were performed (104 robotic and 121 open). Baseline characteristics were similar between groups (p>0.05). All patients were continent and 74% were potent prior to surgery. Mean estimated blood loss (280 cc vs. 760 cc; p<0.001) and blood transfusion (0% vs. 8.3%; p=0.002) was lower in the robotic cohort. Non-transfusion complications were similar between groups (13% vs. 12%; p=0.7). Mean hospital stay was shorter in the robotic cohort (1.4 vs. 2.5 days). There was no difference in overall positive margin rate (38% vs. 43%; p=0.4) or treatment failure at a median followup of 3.5 years (p=0.4). Robotically treated patients were more often continent (89% vs. 77%; p=0.02) and potent (48% vs. 32%; p=0.02).Conclusions: Using an inclusive multi-surgeon approach, robotic prostatectomy was introduced safely at a Canadian academic institution.