The BAUS Radical Prostatectomy audit – an update on current practice (2014).
BAUS ePoster online library. Miller C. 06/30/16; 132001; P10-1
Ms. Catherine Miller
Ms. Catherine Miller
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Abstract
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P10-1

Introduction:

As part of the Consultants Outcomes Publications programme, data on radical prostatectomy (RP) practice during 2014 were made ‘public-facing’ for the first time.

Methods:

Individual surgeons/units uploaded their data on RP to the electronic BAUS data registry. Once extracted, data were transferred to an Access™ database for validation prior to analysis using Tableau™ software.

Results:

Details on 6,651 RP were uploaded from 157 consultants at 71 sites (87% of all RP in England). Median number of RP per surgeon was 31 (1-157) with a median per centre of 77 RP (compared to 16 and 38 respectively in 2013). 25% of centres perform less than 50 RP per year. Commonest surgical approaches were open (13.4%), laparoscopic (26.7%) and robotic (58.5%).  Transfusion rates vary with surgical approach–open (6.5%), laparoscopic (0.8%) and robotic (2.9%). Median length of stay varies markedly – open(3d), laparoscopic(2d) and robotic(1d). Lymph node dissection (LND) is performed in 42% of RP, but only 45% received extended LND. 57% of patients have nerve sparing (28% unilateral/23%bilateral). Approximately 1 in 4 RPs are ‘training cases’, but only 14% are with trainees suggesting a high level of consultant upskilling. Positive margins rates (pT2) are lowest with robotic surgery (13.61%) compared to open/lap (19%).

Conclusions:

Compliance with data registry of RP is high in England and, for the first time, allows an accurate ‘snapshot’ of current practice. Most patients undergo RP by high volume surgeons in high volume centres. Length of stay/positive margin rates are lowest with robotic surgery. Reported transfusion rates are lower with minimally invasive approaches.

P10-1

Introduction:

As part of the Consultants Outcomes Publications programme, data on radical prostatectomy (RP) practice during 2014 were made ‘public-facing’ for the first time.

Methods:

Individual surgeons/units uploaded their data on RP to the electronic BAUS data registry. Once extracted, data were transferred to an Access™ database for validation prior to analysis using Tableau™ software.

Results:

Details on 6,651 RP were uploaded from 157 consultants at 71 sites (87% of all RP in England). Median number of RP per surgeon was 31 (1-157) with a median per centre of 77 RP (compared to 16 and 38 respectively in 2013). 25% of centres perform less than 50 RP per year. Commonest surgical approaches were open (13.4%), laparoscopic (26.7%) and robotic (58.5%).  Transfusion rates vary with surgical approach–open (6.5%), laparoscopic (0.8%) and robotic (2.9%). Median length of stay varies markedly – open(3d), laparoscopic(2d) and robotic(1d). Lymph node dissection (LND) is performed in 42% of RP, but only 45% received extended LND. 57% of patients have nerve sparing (28% unilateral/23%bilateral). Approximately 1 in 4 RPs are ‘training cases’, but only 14% are with trainees suggesting a high level of consultant upskilling. Positive margins rates (pT2) are lowest with robotic surgery (13.61%) compared to open/lap (19%).

Conclusions:

Compliance with data registry of RP is high in England and, for the first time, allows an accurate ‘snapshot’ of current practice. Most patients undergo RP by high volume surgeons in high volume centres. Length of stay/positive margin rates are lowest with robotic surgery. Reported transfusion rates are lower with minimally invasive approaches.

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