TY - JOUR
T1 - Predictors of operative time during radical retropubic prostatectomy and robot-assisted laparoscopic prostatectomy
AU - Simon, Ross M.
AU - Howard, Lauren E.
AU - Moreira, Daniel M.
AU - Terris, Martha K.
AU - Kane, Christopher J.
AU - Aronson, William J.
AU - Amling, Christopher L.
AU - Cooperberg, Matthew R.
AU - Freedland, Stephen J.
N1 - Publisher Copyright:
© 2017 The Japanese Urological Association
PY - 2017/8
Y1 - 2017/8
N2 - Objectives: To better predict operative time using patient/surgical characteristics among men undergoing radical retropubic prostatectomy or robot-assisted laparoscopic prostatectomy in order to achieve more efficient operative scheduling and potentially decrease costs in the Veterans Health System. Methods: We analyzed 2619 men treated with radical retropubic prostatectomy (n = 2005) or robot-assisted laparoscopic prostatectomy (n = 614) from 1993 to 2013 from six Veterans Affairs Hospitals in the Shared Equal Access Regional Cancer Hospital database. Age, body mass index, race, biopsy Gleason, prostate weight, undergoing a nerve-sparing procedure or lymph node dissection, and hospital surgical volume were analyzed in multivariable linear regression to identify predictors of operative time and to quantify the increase/decrease observed. Results: In men undergoing radical retropubic prostatectomy, body mass index, black race, prostate weight and a lymph node dissection all predicted longer operative times (all P ≤ 0.004). In men undergoing robot-assisted laparoscopic prostatectomy, biopsy Gleason score and a lymph node dissection were associated with increased operative time (P ≤ 0.048). In both surgical methods, a lymph node dissection added 25–40 min to the operation. Also, in both, each additional operation per year per center predicted a 0.80–0.89-min decrease in operative time (P ≤ 0.001). Conclusions: Overall, several factors seem to be associated with quantifiable changes in operative time. If confirmed in future studies, these findings can allow for a more precise estimate of operative time, which could decrease the overall cost to the patient and hospital by aiding in operating room time management.
AB - Objectives: To better predict operative time using patient/surgical characteristics among men undergoing radical retropubic prostatectomy or robot-assisted laparoscopic prostatectomy in order to achieve more efficient operative scheduling and potentially decrease costs in the Veterans Health System. Methods: We analyzed 2619 men treated with radical retropubic prostatectomy (n = 2005) or robot-assisted laparoscopic prostatectomy (n = 614) from 1993 to 2013 from six Veterans Affairs Hospitals in the Shared Equal Access Regional Cancer Hospital database. Age, body mass index, race, biopsy Gleason, prostate weight, undergoing a nerve-sparing procedure or lymph node dissection, and hospital surgical volume were analyzed in multivariable linear regression to identify predictors of operative time and to quantify the increase/decrease observed. Results: In men undergoing radical retropubic prostatectomy, body mass index, black race, prostate weight and a lymph node dissection all predicted longer operative times (all P ≤ 0.004). In men undergoing robot-assisted laparoscopic prostatectomy, biopsy Gleason score and a lymph node dissection were associated with increased operative time (P ≤ 0.048). In both surgical methods, a lymph node dissection added 25–40 min to the operation. Also, in both, each additional operation per year per center predicted a 0.80–0.89-min decrease in operative time (P ≤ 0.001). Conclusions: Overall, several factors seem to be associated with quantifiable changes in operative time. If confirmed in future studies, these findings can allow for a more precise estimate of operative time, which could decrease the overall cost to the patient and hospital by aiding in operating room time management.
KW - lymph node excision
KW - operative time
KW - prostate
KW - prostatectomy
KW - robotic
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U2 - 10.1111/iju.13393
DO - 10.1111/iju.13393
M3 - Article
C2 - 28697533
AN - SCOPUS:85026416269
SN - 0919-8172
VL - 24
SP - 618
EP - 623
JO - International Journal of Urology
JF - International Journal of Urology
IS - 8
ER -