Abstract: PD53-12
Sources of Funding: None

Introduction

In 2007, Lowrance et al published a manuscript in the Journal of Urology, which stated that the majority of United States trained urology residents have minimal experience with Retroperitoneal Lymphadenectomy. The purpose of our study is to evaluate if the current trend in retroperitoneal lymphadenectomy training has declined further.

Methods

After permission from the American Board of Urology, a retrospective review of operative log reports from 2005-2015 was performed. Using CPT code designation, total cases performed were quantified and further stratified by log year, practice region, practice type and recertification versus primary certification.

Results

A total of 1227 open retroperitoneal transabdominal lymphadenectomy; extensive, including pelvic, aortic and renal nodes (CPT 38780) were logged by 500 physicians. 247 (49.4%) physicians applying for primary certification logged at least 1 lymphadenectomy compared to 253 (50.6%) applicants for recertification. Of the 500 certifying physicians, 321 (64.2%) reported only 1 lymphadenectomy, 144 (28.8%) reported 2-5 procedures and 35 (7.0%) performed more than 5. When stratified by geographic location, most procedures were recorded in the North Central (27.5%) and Western section (24.4%). There were 793 (64.6%) cases performed in an Academic hospital setting.

Conclusions

A significant number of recently trained urologists continue to demonstrate minimal experience with retroperitoneal lymph node dissection. With limited exposure to an operation that was once considered an index case, there is a significant negative impact on the quality of urologic resident education. Additionally, this review demonstrates an already visible trend toward the centralization of care with the majority of procedures performed at major academic institutions.

Funding

None