دورية أكاديمية
A Safe teaching protocol of LRP (laparoscopic radical prostatectomy).
| العنوان: | A Safe teaching protocol of LRP (laparoscopic radical prostatectomy). |
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| المؤلفون: | Tobias-Machado M; Departamento de Urologia, Faculdade de Medicina ABC, Santo André, SP, Brasil., Pazeto CL; Departamento de Urologia, Faculdade de Medicina ABC, Santo André, SP, Brasil., Neves-Neto OC; Departamento de Urologia, Faculdade de Medicina ABC, Santo André, SP, Brasil., Nunes-Silva I; Instituto do Câncer Arnaldo Vieira de Carvalho - IAVC , São Paulo, SP, Brasil., Zampolli HC; Instituto do Câncer Arnaldo Vieira de Carvalho - IAVC , São Paulo, SP, Brasil. |
| المصدر: | International braz j urol : official journal of the Brazilian Society of Urology [Int Braz J Urol] 2018 Mar-Apr; Vol. 44 (2), pp. 273-279. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Brazilian Society of Urology Country of Publication: Brazil NLM ID: 101158091 Publication Model: Print Cited Medium: Internet ISSN: 1677-6119 (Electronic) Linking ISSN: 16775538 NLM ISO Abbreviation: Int Braz J Urol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Rio de Janerio, RJ, Brazil : Brazilian Society of Urology, [2002]- |
| مواضيع طبية MeSH: | Education, Medical, Continuing* , Learning Curve*, Laparoscopy/*education , Prostatectomy/*education , Prostatic Neoplasms/*surgery, Aged ; Humans ; Male ; Middle Aged ; Operative Time ; Retrospective Studies |
| مستخلص: | Purpose: The LRP has a steep learning curve to obtain proficiency during which patient safety may be compromised. We present an adapted modular training system which purpose to optimize the learning curve and perform a safe surgery. Materials and Methods: A retrospective analysis of the LRP safe learning protocol applied during a fellowship program over eight years (2008-2015). The surgery was divided in 12 steps and 5 levels of difficulty. A maximum time interval was stipulated in 240 minutes. After an adaptation, the fellows had 120 minutes to perform all the corresponding modules to its accumulated skill. The participants gradually and safely pass through the steps and difficulty levels. Surgeries performed by fellows were analyzed as a single group and compared to a prior series performed by tutor. Results: In eight years, 250 LRP were performed (25 per apprentice) during fellowship program and 150 procedures after completion. The baseline characteristics were comparable. Most cases operated were of intermediate risk. Mean operative time was longer in the fellow group when compared to the tutor (150 min). Mean estimated blood loss were similar among the groups. Functional and oncological outcomes were better in the Tutor´s group. No conversion to open surgery was performed. Conclusions: The LRP safe learning protocol proved to be an effective method to optimize the learning curve and perform safe surgery. However, the tutor's functional and oncological results were better, showing that this is a procedure with a steep learning curve and proficiency demands more than 25 cases. Competing Interests: Conflict of interest: None declared. (Copyright® by the International Brazilian Journal of Urology.) |
| References: | Actas Urol Esp. 2010 Jul;34(7):598-602. (PMID: 20540876) Surg Oncol Clin N Am. 2013 Jan;22(1):125-41, vii. (PMID: 23158089) Eur Urol. 2007 Jan;51(1):45-55; discussion 56. (PMID: 16854519) J Urol. 2010 Dec;184(6):2291-6. (PMID: 20952022) Actas Urol Esp. 2007 Mar;31(3):205-10. (PMID: 17658149) Can Urol Assoc J. 2014 Jan-Feb;8(1-2):E68-72. (PMID: 24454607) Eur Urol. 2005 Feb;47(2):167-75. (PMID: 15661410) Urology. 1997 Dec;50(6):854-7. (PMID: 9426713) ANZ J Surg. 2015 Mar;85(3):154-8. (PMID: 24730750) Surg Endosc. 2004 May;18(5):829-33. (PMID: 15216868) Urol Clin North Am. 2001 Feb;28(1):189-202. (PMID: 11277064) Int Braz J Urol. 2016 Jan-Feb;42(1):83-9. (PMID: 27136471) J Urol. 2003 Jun;169(6):2063-5. (PMID: 12771720) J Urol. 2009 Sep;182(3):949-55. (PMID: 19616260) Urol Oncol. 2009 Mar-Apr;27(2):144-8. (PMID: 18367119) Actas Urol Esp. 2009 Mar;33(3):290-5. (PMID: 19537067) Eur Urol. 2006 Mar;49(3):491-8; discussion 499-500. (PMID: 16359780) Ann Surg. 2004 Aug;240(2):205-13. (PMID: 15273542) J Endourol. 2006 Oct;20(10):831-5. (PMID: 17094764) J Urol. 2016 Jul;196(1):76-81. (PMID: 26860793) |
| فهرسة مساهمة: | Keywords: Education; Prostatectomy; Surgical Procedures, Operative |
| تواريخ الأحداث: | Date Created: 20170831 Date Completed: 20180524 Latest Revision: 20181113 |
| رمز التحديث: | 20221213 |
| مُعرف محوري في PubMed: | PMC6050564 |
| DOI: | 10.1590/S1677-5538.IBJU.2017.0137 |
| PMID: | 28853815 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1677-6119 |
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| DOI: | 10.1590/S1677-5538.IBJU.2017.0137 |