caa a22 4500 445334932 CHVBK 20180317142751.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1245/s10434-010-1300-0 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1300-0 Impact of Surgical Experience on In-Hospital Complication Rates in Patients Undergoing Minimally Invasive Prostatectomy: A Population-Based Study [Elektronische Daten] [Lars Budäus, Maxine Sun, Firas Abdollah, Kevin Zorn, Monica Morgan, Rupinder Johal, Daniel Liberman, Rodolphe Thuret, Hendrik Isbarn, Georg Salomon, Alexander Haese, Francesco Montorsi, Shahrokh Shariat, Paul Perrotte, Markus Graefen, Pierre Karakiewicz] Background: The relationship between provider volume and complication and transfusion rates in patients undergoing minimally invasive prostatectomy (MIRP) for prostate cancer has not been assessed. Temporal trends in MIRP annual surgical caseload (AC), impact of MIRP surgical experience (SE), and in-hospital complication and transfusion rates were evaluated. Methods: Between 2002 and 2008, 2,666 patients in Florida underwent MIRP. Surgical experience was defined as the number of procedures performed from the beginning of the study until each individual MIRP. Multivariable logistic regression models using generalized estimating equations assessed the relationship between SE and in-hospital complication and transfusion rates. Results: Overall AC and SE ranged from 1-171 and 1-500, respectively. Between 2002 and 2005, 94-100% of surgeons were considered as low AC tertile (≤15 MIRP) vs. 76-82% between 2006 and 2008. For the same time periods, low AC tertile surgeons performed 46-100 and 27-32% of all MIRPs respectively. Multivariable logistic regression models revealed 51 and 68% lower complication rates in patients operated on by surgeons of intermediate (17-76 MIRPs) and high SE (≥77 MIRPs) relative to surgeons of low SE (≤16 MIRPs). Similarly, transfusion rates were 80 and 83% lower for the same groups. Conclusions: Our study is the first to indicate that high SE reduces MIRP complication and transfusion rates. Despite this observation, even in the most contemporary study year, most MIRP surgeons (82%) were in the low AC tertile and contributed to as many as 32% of all MIRPs. These findings should be considered at informed consent. Society of Surgical Oncology, 2010 Budäus Lars Martiniclinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany aut Sun Maxine Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut Abdollah Firas Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut Zorn Kevin Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut Morgan Monica Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut Johal Rupinder Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut Liberman Daniel Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut Thuret Rodolphe Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut Isbarn Hendrik Martiniclinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany aut Salomon Georg Martiniclinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany aut Haese Alexander Martiniclinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany aut Montorsi Francesco Vita-Salute San Raffaele University, Milan, Italy aut Shariat Shahrokh Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut Perrotte Paul Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut Graefen Markus Martiniclinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany aut Karakiewicz Pierre Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 839-847 1068-9265 18:3<839 2011 18 10434 https://doi.org/10.1245/s10434-010-1300-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1300-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Budäus Lars Martiniclinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Sun Maxine Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut NATIONALLICENCE 700 1- Abdollah Firas Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut NATIONALLICENCE 700 1- Zorn Kevin Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut NATIONALLICENCE 700 1- Morgan Monica Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut NATIONALLICENCE 700 1- Johal Rupinder Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut NATIONALLICENCE 700 1- Liberman Daniel Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut NATIONALLICENCE 700 1- Thuret Rodolphe Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut NATIONALLICENCE 700 1- Isbarn Hendrik Martiniclinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Salomon Georg Martiniclinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Haese Alexander Martiniclinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Montorsi Francesco Vita-Salute San Raffaele University, Milan, Italy aut NATIONALLICENCE 700 1- Shariat Shahrokh Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut NATIONALLICENCE 700 1- Perrotte Paul Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut NATIONALLICENCE 700 1- Graefen Markus Martiniclinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Karakiewicz Pierre Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 839-847 1068-9265 18:3<839 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer