Learning curve for robot-assisted laparoscopic radical prostatectomy for pathologic t2 disease.
OBJECTIVE
To investigate the learning curve for robot-assisted laparoscopic radical prostatectomy (RALP) for pathologic T2 disease, we examined differences in perioperative outcomes according to time period.


METHODS
Between July 2005 and June 2008, a total of 307 consecutive patients underwent RALP for prostate cancer and 205 patients had pathologic T2 disease. Patients were grouped into 6-month time periods. We collected and examined the patient's perioperative data including age, body mass index (BMI), prostate-specific antigen (PSA), operation time, estimated blood loss, and positive surgical margin.


RESULTS
There were no significant differences among the groups in age (p=0.705), BMI (p=0.246), PSA (p=0.425), or prostate volume (p=0.380). Operation time (p<0.001) and estimated blood loss (p<0.001) decreased significantly with time. The positive surgical margin rate also showed a decreasing trend, but this was not significant (p=0.680).


CONCLUSIONS
Operation time and estimated blood loss had a steep learning curve during the early 24 cases and then stabilized. A positive surgical margin rate, however, did not have a significant learning curve, although the positive surgical margin decreased continuously.
Lee
Jae Won
JW
Department of Urology, College of Medicine, Hanyang University, Seoul, Korea.
Jeong
Woo Ju
WJ
Park
Sung Yul
SY
Loreazo
Enrique I S
EI
Oh
Cheol Kyu
CK
Rha
Koon Ho
KH