Current evidence between hospital volume and perioperative outcome: Prospective assessment of robotic radical prostatectomy safety profile in a regional center of medium annual caseload

  • Matteo Ferrari
  • Brunello Mazzola
  • Enrico Roggero
  • Eugenia D'Antonio
  • Ricardo Pereira Mestre
  • Giovanni Porcu
  • Flavio Stoffel
  • Julien Renard
Keywords: hospital volume, post-operative complication, robotic radical prostatectomy, standardized reporting, surgical outcome

Abstract

Introduction: We aimed to present the safety profile of robotic radical prostatectomy (RARP) performed in a single center of medium surgical volume since its introduction and identify predictors of postoperative complications.

Methods: We prospectively collected clinical data from 317 consecutive patients undergoing RARP between August 2011 and November 2019 in a medium-volume center. Surgical procedures were performed by a single experienced surgeon. Complications were collected according to the Martin criteria for reporting and the Clavien-Dindo classification for rating. Preoperative, intraoperative, and postoperative data were analyzed and compared with available literature.

Results: A total of 102 complications were observed in 96 (30.3%) patients and were minor in 84.4% of cases (Clavien grade 1 and 2). Transfusion rate was 1.3%. Complications of grade 4b or 5 did not occur. The most frequent complications were urinary retention (7.3%) and anastomotic leak (5.9%). At multivariate analysis, the nerve-sparing technique was an independent predictor of complications (odds ratio [OR] 0.55, p=0.02).

Conclusions: The study shows that a high safety profile may be achieved in a medium-volume hospital. The nerve-sparing technique was a predictor of complications. Further studies are needed to define the current relationship between surgical volume and perioperative outcome for RARP.

Author Biographies

Matteo Ferrari

Division of Urology

Brunello Mazzola

Division of Urology

Enrico Roggero
Clinic of Medical Oncology
Eugenia D'Antonio
Clinic of Medical Oncology
Ricardo Pereira Mestre
Clinic of Medical Oncology
Giovanni Porcu

Division of Urology

Flavio Stoffel

Division of Urology

Julien Renard

Division of Urology

Published
2020-08-07
How to Cite
Ferrari, M., Mazzola, B., Roggero, E., D’Antonio, E., Pereira Mestre, R., Porcu, G., Stoffel, F., & Renard, J. (2020). Current evidence between hospital volume and perioperative outcome: Prospective assessment of robotic radical prostatectomy safety profile in a regional center of medium annual caseload. Canadian Urological Association Journal, 15(3), E153-9. https://doi.org/10.5489/cuaj.6547
Section
Original Research