PD41-11 SAFETY OF LIVE SURGERY IN UROLOGY. PROPENSITY SCORED MATCHED ANALYSIS

Abstract

You have accessJournal of UrologySurgical Technology & Simulation: Training & Skills Assessment II1 Apr 2017PD41-11 SAFETY OF LIVE SURGERY IN UROLOGY. PROPENSITY SCORED MATCHED ANALYSIS Gabriel Ogaya, Eduardo Hernandez-Cardona, Hariahran Palayapalayam, Xavier Bonet, Cathy Jenson, and Vipul Patel Gabriel OgayaGabriel Ogaya More articles by this author , Eduardo Hernandez-CardonaEduardo Hernandez-Cardona More articles by this author , Hariahran PalayapalayamHariahran Palayapalayam More articles by this author , Xavier BonetXavier Bonet More articles by this author , Cathy JensonCathy Jenson More articles by this author , and Vipul PatelVipul Patel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1890AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Live surgery events (LSE), have become one of the most attended activities at surgical meetings, providing a unique opportunity for surgeons to observe in real time, the decision-making process by skilled and experienced surgeons. However, there is an ongoing discussion on whether patients who are treated during LSE are at a higher risk for complications. The purpose of this study is to examine the safety of live robotic-assisted radical prostatectomy (RARP) cohort, performed in our institution by a single surgeon and to provide evidence on this practice. METHODS From January 2008 through April 2016, >9000 patients underwent RARP at our institution, performed by a single surgeon. From this group, 36 patients underwent live transmission via video link from our institution to an external cogress of RARP. A propensity-matched analysis was conducted, in a 1:3 proportion, comparing outcomes of live transmission cases to those operated under regular circumstances. Postoperative outcomes were analyzed between the live surgery (LS) group (n=36) and the propensity-matched group (control group; n=108). RESULTS There were no significant demographic differences between the two groups regarding the comorbidities, clinical tumor stage, pre-operative PSA, biopsy Gleason score, body mass index (BMI), pre-operative SHIM score and AUA symptoms score and D′Amico class. The only significant difference in the demographic was the age: 55.42 ± 7.33 y.o for the LS group vs. 58.76 ± 6.24 y.o for the control group (p= 0.016). The operative time was longer in the LS group when compared to the control: 136.14 min ± 24.29 vs. 122.43 min ± 23.72, respectively (p= 0.0036), however, the console time was shorter for the LS group 72.6 min ± 10.41 compared to the 76.48 min ± 9.42, of the control group (p= 0.0402). No major complications were reported in any of the groups, and only 4 minor complications were observed in the control group (p= 0.2415). After a median follow-up of 31.17 ±≥ 19.17 months, only one patient (2.77%) in the live surgery group presented biochemical recurrence vs. four (3.71%) in the control group (p= 0.7927). No differences were seen in the continence rate, 97.22% for both groups, and no differences were observed in the potency rate for either group: 69.44% for the LS group vs. 67.59% in the control group (p=0.4034). CONCLUSIONS In this series of live transmission of RARP, the perioperative results (oncological/ functional outcomes and complications) were similar to those found in daily practice. These findings suggest that LS of this procedure in selected patients and selected centers is safe. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e811 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Gabriel Ogaya More articles by this author Eduardo Hernandez-Cardona More articles by this author Hariahran Palayapalayam More articles by this author Xavier Bonet More articles by this author Cathy Jenson More articles by this author Vipul Patel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

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