title: Videotaping of surgical procedures and outcomes following extraperitoneal laparoscopic radical prostatectomy for clinically localized prostate cancer.
abstract: BACKGROUND
  Video-recording of emerging minimally invasive surgical procedures is likely to become an integral component of patient record-keeping in the future for prostate cancer treatment. No prior work has shown the impact of videotaping of laparoscopic prostatectomy on patient outcomes. Our aim was to determine correlation between independent peer review of videotaping quality scores of extraperitoneal laparoscopic prostatectomy (ELRP) with complications, re-admissions, functional, and early oncological outcomes.
  
  
  METHODS
  We conducted a single-institution prospective cohort study comparing videotaping quality scores with the outcomes of ELRP in men with localized prostate cancer. Videotaping of surgical procedures were scored by two experienced laparoscopic surgeons using a validated scoring method. Validated record-linkage methodology and self-reported questionnaires were used to assess surgical complications, re-admissions, functional, and oncological outcomes based on a common identifier called as community health index (CHI) number. Pearson correlation coefficients were calculated between the different covariates with statistical significance considered at P < 0.05. Multivariate analyses assessed oncological outcomes (positive surgical margins/biochemical recurrence), post-operative complications, and re-admission into hospital following initial hospital discharge with quality of surgical procedure.
  
  
  RESULTS
  200 men were recruited into the study. 51 (25.5%) participants had post-operative complications. Record-linkage methodology identified 18 (9%) participants had re-admissions within 90 days of the procedure. 13 (6.5%) of these men required percutaneous drainage with hospital stay following re-admissions ranged between 3 and 12 days. 10 (5.0%) participants had intra/peri-operative complications. 23 (11.5%) men reported to primary care physicians for various indications. Higher quality surgical technique videotaped scores (assessed by independent peer review) had a significant correlation with early continence recovery at 3 months post-procedure, (P = 0.013), but lost statistical significance with overall continence at 1 year. No statistical correlation was observed between videotaped scores and oncological outcomes (positive surgical margins/biochemical recurrence), post-operative complications, and readmission into hospital.
  
  
  CONCLUSIONS
  Quality of surgical procedure assessed by independent third party videotaping score predicted early resumption of continence following extraperitoenal laparoscopic radical prostatectomy, however, it did not predict complications, oncological or functional outcome as assessed using patient reported outcomes at 12 months. J. Surg. Oncol. 2016;114:1016-1023. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Academic Section of Urology, School of Medicine, University of Dundee, Dundee, Scotland.
authors.forename: Catherine
authors.initials: C
authors.lastname: Paterson
authors.forename: Sarah
authors.initials: S
authors.lastname: McLuckie
authors.affiliation: Academic Section of Urology, School of Medicine, University of Dundee, Dundee, Scotland.
authors.forename: Chin
authors.initials: C
authors.lastname: Yew-Fung
authors.affiliation: Cuscheiri Skills Centre, School of Medicine, University of Dundee, Dundee, Scotland.
authors.forename: Benjie
authors.initials: B
authors.lastname: Tang
authors.affiliation: Academic Section of Urology, School of Medicine, University of Dundee, Dundee, Scotland.
authors.forename: Stephen
authors.initials: S
authors.lastname: Lang
authors.affiliation: Academic Section of Urology, School of Medicine, University of Dundee, Dundee, Scotland.
authors.forename: Ghulam
authors.initials: G
authors.lastname: Nabi
mesh_terms: D000368:Aged; D002983:Clinical Competence; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000592:standards; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data; D018024:Peer Review, Health Care; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods* / Q000592:standards; D011471:Prostatic Neoplasms / Q000601:surgery*; D011785:Quality Assurance, Health Care / Q000379:methods*; D016896:Treatment Outcome; D014741:Video Recording
keywords: extraperitoneal laparoscopic prostatectomy; functional; oncological; prostate cancer; record-linkage methodology