Login to Access Video or Poster Abstract: MP96-04
Sources of Funding: None

Introduction

It is documented that the level of experience and number of operations that a consultant does affects the outcome for the patient. Is this also true when a resident or fellow operates on a patient under direct consultant supervision?_x000D_ The aim of this study is to compare the perioperative, cancer and continence outcomes for men undergoing an open radical prostatectomy performed by either a training surgeon or a consultant urologist in a teaching hospital._x000D_

Methods

We prospectively collected data from radical prostatectomies performed by four consultants and all urology residents and fellows between January 2010 and February 2015._x000D_ The outcome measures presented in this paper are length of operation, blood loss, incidence of positive margins and pad usage at one year. Results were analysed using the unpaired student's t test and Fishers exact test.

Results

428 men underwent radical prostatectomy at Christchurch Hospital during this time. Age ranged from 41-76 year with a median of 65 years._x000D_ 351(82%) completed the pad usage surveys at one year._x000D_ Overall 73% were performed completely by the consultants and the trainee performed 27%. _x000D_ Median operating time was 105 minutes (range 42-184 mins)_x000D_ Median blood loss was 500mls (range 100-3000mls)_x000D_ Table one shows comparison of the operating times and blood loss between consultants and trainees performing the operations._x000D_ 14 men (4%) used 2 pads a day, only two had had their surgery performed by the trainees. 12 men (3.4%) used 3 or more pads a day at one year. These patients were evenly split between the consultant and the trainees. (Table 2) The overall continence status of the two groups showed no significant difference (p = 0.6298)_x000D_ 32.6 % of men undergoing surgery by a training surgeon had a positive margin compared with 36.6% of those operated on by a qualified urologist (p=0.8673)_x000D_ _x000D_ Table 1 Blood loss and operating time_x000D_ Operator status Consultant Trainee P value_x000D_ Length of operation mins 100 (42-180) 120 (61-184) <0.0001_x000D_ Blood loss mls 500 (100-3000) 600 (100-1700) 0.9081_x000D_ _x000D_ Table 2 Continence Outcomes_x000D_ Operator status Consultant Trainee_x000D_ n (%) n (%)_x000D_ Dry 163 (64) 63 (66)_x000D_ One pad 75 (29) 24 (25)_x000D_ Two pads 12 (5) 2 (2)_x000D_ Three or more pads 6 (2) 6 (6)_x000D_

Conclusions

Surgeries performed by a supervised trainee surgeon have the same outcomes as those performed by a qualified urologist.

Funding

None