Impact of Patient Factors on Robotic-Assisted Partial Nephrectomy Operating Room Times: The Case for Fixed Operating Room Time as a Viable Efficiency Target.

IF 2.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Journal of endourology Pub Date : 2025-02-01 Epub Date: 2024-12-26 DOI:10.1089/end.2024.0330
Neda Qosja, Laura E Geldmaker, Christopher H Hasse, Vartika Tiwari, Taylor R Fuqua, Daniela A Haehn, Colleen S Thomas, Alex Hochwald, David D Thiel
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Abstract

Introduction: To analyze the association of patient characteristics on operating room (OR) times for robotic-assisted partial nephrectomies (RAPNs). Methods: In total, 248 consecutive RAPNs were performed by a single surgeon from October 2018 to August 2022. Data were collected on the following patient factors: sex, age, race, weight, body mass index (BMI), diabetes, hypertension (HTN), tumor side, tumor mass, and American Society of Anesthesiologists (ASA) score. Total fixed OR times were evaluated as the sum of in-room time to anesthesia-release time (IRAT), anesthesia-release time to cut time (ARCT), close time to wheels out time (CTWO), and in-room time to cut time (IRAT + ARCT). Total variable OR times were defined as cut time to close time (CTCT). Total operative time was defined as wheels into wheel out (WIWO). Results: Median OR time was 265 minutes (interquartile range [IQR]: 247-298 minutes) for WIWO, 191 minutes (IQR: 170-225 minutes) for CTCT, and 75 minutes (IQR: 68-83 minutes) for total fixed time. There was a significant increase in WIWO with the following patient variables: male sex (18.0 minutes, 95% confidence interval [CI]: 6.3-29.7 minutes), weight (5.6 minutes, 95% CI: 2.8-8.4 minutes), BMI (14.3 minutes, 95% CI: 4.2-24.4 minutes), HTN (15.1 minutes, 95% CI: 3.7-26.5 minutes), pathology tumor size (cm) (6.4 minutes, 95% CI: 2.2-10.6 minutes), and ASA score (13.8 minutes, 95% CI: 3.1-24.4 minutes). Sex, age, BMI, weight, HTN, and pathology tumor size significantly impacted CTCT (P < 0.05). Total fixed OR time was only affected by ASA score (P = 0.02). Conclusions: Patient variables significantly affect total OR time and variable OR time. These variables do not impact total fixed OR times, confirming fixed OR time as a viable OR efficiency point.

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患者因素对机器人辅助部分肾切除术手术时间的影响:将固定手术时间作为可行的效率目标。
前言:分析机器人辅助部分肾切除术(rapn)患者特征与手术室(OR)次数的关系。方法:2018年10月至2022年8月,同一位外科医生共实施了248例rapn。收集以下患者因素的数据:性别、年龄、种族、体重、体重指数(BMI)、糖尿病、高血压(HTN)、肿瘤一侧、肿瘤质量和美国麻醉医师协会(ASA)评分。总固定手术时间计算为室内时间至麻醉释放时间(IRAT)、麻醉释放时间至切口时间(ARCT)、闭合时间至轮出时间(CTWO)和室内时间至切口时间(IRAT + ARCT)的总和。总可变OR时间定义为切断时间到关闭时间(CTCT)。总手术时间定义为车轮进车轮出(WIWO)。结果:WIWO的中位手术时间为265分钟(四分位数间距[IQR]: 247-298分钟),CTCT的中位手术时间为191分钟(IQR: 170-225分钟),总固定时间为75分钟(IQR: 68-83分钟)。WIWO的显著增加与以下患者变量有关:男性(18.0分钟,95%可信区间[CI]: 6.3-29.7分钟)、体重(5.6分钟,95% CI: 2.8-8.4分钟)、BMI(14.3分钟,95% CI: 4.2-24.4分钟)、HTN(15.1分钟,95% CI: 3.7-26.5分钟)、病理肿瘤大小(cm)(6.4分钟,95% CI: 2.2-10.6分钟)和ASA评分(13.8分钟,95% CI: 3.1-24.4分钟)。性别、年龄、BMI、体重、HTN、病理肿瘤大小对CTCT有显著影响(P < 0.05)。总固定OR时间仅受ASA评分影响(P = 0.02)。结论:患者变量显著影响总手术时间和可变手术时间。这些变量不影响总固定或时间,确认固定或时间是可行的或效率点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of endourology
Journal of endourology 医学-泌尿学与肾脏学
CiteScore
5.50
自引率
14.80%
发文量
254
审稿时长
1 months
期刊介绍: Journal of Endourology, JE Case Reports, and Videourology are the leading peer-reviewed journal, case reports publication, and innovative videojournal companion covering all aspects of minimally invasive urology research, applications, and clinical outcomes. The leading journal of minimally invasive urology for over 30 years, Journal of Endourology is the essential publication for practicing surgeons who want to keep up with the latest surgical technologies in endoscopic, laparoscopic, robotic, and image-guided procedures as they apply to benign and malignant diseases of the genitourinary tract. This flagship journal includes the companion videojournal Videourology™ with every subscription. While Journal of Endourology remains focused on publishing rigorously peer reviewed articles, Videourology accepts original videos containing material that has not been reported elsewhere, except in the form of an abstract or a conference presentation. Journal of Endourology coverage includes: The latest laparoscopic, robotic, endoscopic, and image-guided techniques for treating both benign and malignant conditions Pioneering research articles Controversial cases in endourology Techniques in endourology with accompanying videos Reviews and epochs in endourology Endourology survey section of endourology relevant manuscripts published in other journals.
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