Evaluation of Peri-operative Outcomes Associated With Resident Involvement on Tumor Resection and Renorrhaphy During Robotic-assisted Partial Nephrectomy

Amanda A Myers; Laura E Geldmaker; Daniela A Haehn; Essa M Bajalia; Colleen T Ball; David D Thiel

doi:10.1016/j.urology.2021.08.022

Back

Evaluation of Peri-operative Outcomes Associated With Resident Involvement on Tumor Resection and Renorrhaphy During Robotic-assisted Partial Nephrectomy

Journal article

Peer reviewed

Evaluation of Peri-operative Outcomes Associated With Resident Involvement on Tumor Resection and Renorrhaphy During Robotic-assisted Partial Nephrectomy

Amanda A Myers, Laura E Geldmaker, Daniela A Haehn, Essa M Bajalia, Colleen T Ball and David D Thiel

Urology (Ridgewood, N.J.), Vol.157, pp.143-147

11/2021

DOI: 10.1016/j.urology.2021.08.022

PMID: 34461143

View Online

Abstract

To evaluate perioperative outcomes of resident trainee involvement in tumor resection and renorrhaphy during robotic assisted partial nephrectomy (RAPN). We analyzed 500 consecutive RAPN in a single surgeon prospectively maintained database. Cases with resident performed tumor resection and renorrhaphy (N = 71) were case matched on R.E.N.A.L. score and RAPN year using a greedy matching algorithm. Perioperative variables were compared to attending cases. There were no statistically significant differences in high grade postoperative complications (resident: 3% vs attending: 6%, P = .68), positive margins (resident: 1% vs attending: 3%, P = .31), length of stay (resident: 2.0 vs attending: 2.0 days, P = .73), and 30 day readmission (resident: 7% vs attending: 11%, P = .56). However, residents had a statistically significant longer warm ischemia time (median 21 vs 15 minutes, P <.001), thus less likely to achieve trifecta (66% vs 85%, P = .02). Resident involvement had longer median operative time (197 vs 184 minutes, P = .03). No statistically significant difference in functional volume loss (P = .12) or surface intermediate base margin score (P = .66) between residents and attending was found. No difference in post-operative creatinine change was found at 1 day and 1 month (resident: 0.2 vs attending: 0.1 mg/dL, P = .4 and resident: 0.1 vs attending: 0.1 mg/dL, P = .6, respectively). Supervised resident console involvement in tumor resection and renorrhaphy during RAPN is safe and does not increase rates of complications. Residents have longer median warm ischemia time compared to attending only cases, but this does not appear to impact post-operative renal function.

Aged

Creatinine - blood

Female

Humans

Internship and Residency - statistics & numerical data

Kidney - physiopathology

Kidney Neoplasms - surgery

Length of Stay

Male

Medical Staff, Hospital - statistics & numerical data

Middle Aged

Neoplasm, Residual

Nephrectomy - adverse effects

Nephrectomy - education

Nephrectomy - methods

Operative Time

Patient Readmission

Perioperative Period

Postoperative Complications - etiology

Robotic Surgical Procedures - adverse effects

Robotic Surgical Procedures - education

Suture Techniques - adverse effects

Suture Techniques - education

Warm Ischemia

Details

Title: Subtitle: Evaluation of Peri-operative Outcomes Associated With Resident Involvement on Tumor Resection and Renorrhaphy During Robotic-assisted Partial Nephrectomy
Creators: Amanda A Myers - Mayo Clinic in Florida
Laura E Geldmaker - Mayo Clinic in Florida
Daniela A Haehn - Mayo Clinic in Florida
Essa M Bajalia - Mayo Clinic in Florida
Colleen T Ball - Mayo Clinic in Florida
David D Thiel - Mayo Clinic in Florida
Resource Type: Journal article
Publication Details: Urology (Ridgewood, N.J.), Vol.157, pp.143-147
DOI: 10.1016/j.urology.2021.08.022
PMID: 34461143
NLM abbreviation: Urology
ISSN: 0090-4295
eISSN: 1527-9995
Language: English
Date published: 11/2021
Academic Unit: Urology
Record Identifier: 9984934818402771

Metrics

3 Record Views