Poster, Podium & Video Sessions
Presentation Authors: Sharon English*, Christchurch, New Zealand
Introduction: It is documented that the level of experience and number of operations that a consultant does affects the outcome for the patient. Is this also true when a resident or fellow operates on a patient under direct consultant supervision?
The aim of this study is to compare the perioperative, cancer and continence outcomes for men undergoing an open radical prostatectomy performed by either a training surgeon or a consultant urologist in a teaching hospital.
Methods: We prospectively collected data from radical prostatectomies performed by four consultants and all urology residents and fellows between January 2010 and February 2015.
The outcome measures presented in this paper are length of operation, blood loss, incidence of positive margins and pad usage at one year. Results were analysed using the unpaired student's t test and Fishers exact test.
Results: 428 men underwent radical prostatectomy at Christchurch Hospital during this time. Age ranged from 41-76 year with a median of 65 years.
351(82%) completed the pad usage surveys at one year.
Overall 73% were performed completely by the consultants and the trainee performed 27%.
Median operating time was 105 minutes (range 42-184 mins)
Median blood loss was 500mls (range 100-3000mls)
Table one shows comparison of the operating times and blood loss between consultants and trainees performing the operations.
14 men (4%) used 2 pads a day, only two had had their surgery performed by the trainees. 12 men (3.4%) used 3 or more pads a day at one year. These patients were evenly split between the consultant and the trainees. (Table 2) The overall continence status of the two groups showed no significant difference (p = 0.6298)
32.6 % of men undergoing surgery by a training surgeon had a positive margin compared with 36.6% of those operated on by a qualified urologist (p=0.8673)
Table 1 Blood loss and operating time
Operator status Consultant Trainee P value
Length of operation mins 100 (42-180) 120 (61-184) <0.0001
Blood loss mls 500 (100-3000) 600 (100-1700) 0.9081
Table 2 Continence Outcomes
Operator status Consultant Trainee
n (%) n (%)
Dry 163 (64) 63 (66)
One pad 75 (29) 24 (25)
Two pads 12 (5) 2 (2)
Three or more pads 6 (2) 6 (6)
Conclusions: Surgeries performed by a supervised trainee surgeon have the same outcomes as those performed by a qualified urologist.
Source Of Funding: None
Tuesday, May 16
9:30 AM – 11:30 AM