Population-based determinants of radical prostatectomy operative time

摘要: Objectives To determine factors that influence radical prostatectomy (RP) operative times. Operative time assessment is inherent to defining surgeon learning curves and evaluating quality of care. Subjects/Patients Methods Population-based observational cohort study using USA Surveillance, Epidemiology, End Results (SEER)-Medicare linked data men diagnosed with prostate cancer during 2003–2007 who underwent robot-assisted (RARP, 3458 men) retropubic RP (RRP, 6993) through 2009. We obtained median anaesthesia administrative for used regression assess the contribution patient, surgeon, hospital times. Results The RARP decreased from 315 247 min 2003 2008–2009 (P < 0.001), while RRP remained similar (195 vs 197 min, P = 0.90). In adjusted analysis, (parameter estimate [PE] 70.9; 95% confidence interval [CI] 58, 84; 0.001) obesity (PE 15; CI 7, 23; were associated longer times higher volumes shorter 0.001). RPs performed by surgeons employed group –22.76; –38, –7.49; 0.004) non-government –35.59; –68.15, –3.03; 0.032) government facilities non-profit ownership –21.85; –32.28, –11.42; times. Conclusions During our period, 68 min stagnant. Higher volume was times, selective referral or improved efficiency level high-volume would net almost $15 million (USA dollars) in annual savings.