title: Evaluation of the Learning Curve for Transurethral Plasmakinetic Enucleation and Resection of Prostate Using a Mentor-based Approach.
abstract: OBJECTIVE
  To analyze the mentor-based learning curve of one single surgeon with transurethral plasmakinetic enucleation and resection of prostate (PKERP) prospectively.
  
  
  METHODS
  Ninety consecutive PKERP operations performed by one resident under the supervision of an experienced endourologist were studied. Operations were analyzed in cohorts of 10 cases to determine when a plateau was reached for the variables such as operation efficiency, enucleation efficiency and frequency of mentor advice (FMA). Patient demographic variables, perioperative data, complications and 12-month follow-up data were analyzed and compared with the results of a senior urologist.
  
  
  RESULTS
  The mean operative efficiency and enucleation efficiency increased from a mean of 0.49±0.09g/min and 1.11±0.28g/min for the first 10 procedures to a mean of 0.63±0.08g/min and 1.62±0.36g/min for case numbers 31-40 (p=0.003 and p=0.002). The mean value of FMA decreased from a mean of 6.7±1.5 for the first 10 procedures to a mean of 2.8±1.2 for case numbers 31-40 (p<0.01). The senior urologist had a mean operative efficiency and enucleation efficiency equivalent to those of the senior resident after 40 cases. There was significant improvement in 3, 6 and 12 month's parameter compared with preoperative values (p<0.001).
  
  
  CONCLUSIONS
  PKERP can be performed safely and efficiently even during the initial learning curve of the surgeon when closely mentored. Further well-designed trials with several surgeons are needed to confirm the results.
authors.affiliation: Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Lang
authors.initials: L
authors.lastname: Feng
authors.affiliation: Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Song
authors.affiliation: Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Daoxin
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Tian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005500:Follow-Up Studies; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use; D059032:Learning Curve; D008297:Male; D008611:Mentors; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D011446:Prospective Studies; D011467:Prostate / Q000601:surgery*; D011470:Prostatic Hyperplasia / Q000601:surgery; D011788:Quality of Life; D015203:Reproducibility of Results; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000193:education* / Q000379:methods*; D016896:Treatment Outcome
keywords: Prostate ; Transurethral Resection of Prostate