Neda Qosja, Laura E Geldmaker, Christopher H Hasse, Vartika Tiwari, Taylor R Fuqua, Daniela A Haehn, Colleen S Thomas, Alex Hochwald, David D Thiel
{"title":"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。","authors":"Neda Qosja, Laura E Geldmaker, Christopher H Hasse, Vartika Tiwari, Taylor R Fuqua, Daniela A Haehn, Colleen S Thomas, Alex Hochwald, David D Thiel","doi":"10.1089/end.2024.0330","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Introduction:</i></b> To analyze the association of patient characteristics on operating room (OR) times for robotic-assisted partial nephrectomies (RAPNs). <b><i>Methods:</i></b> 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). <b><i>Results:</i></b> 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 (<i>P</i> < 0.05). Total fixed OR time was only affected by ASA score (<i>P</i> = 0.02). <b><i>Conclusions:</i></b> 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.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"121-126"},"PeriodicalIF":2.9000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of Patient Factors on Robotic-Assisted Partial Nephrectomy Operating Room Times: The Case for Fixed Operating Room Time as a Viable Efficiency Target.\",\"authors\":\"Neda Qosja, Laura E Geldmaker, Christopher H Hasse, Vartika Tiwari, Taylor R Fuqua, Daniela A Haehn, Colleen S Thomas, Alex Hochwald, David D Thiel\",\"doi\":\"10.1089/end.2024.0330\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Introduction:</i></b> To analyze the association of patient characteristics on operating room (OR) times for robotic-assisted partial nephrectomies (RAPNs). <b><i>Methods:</i></b> 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). <b><i>Results:</i></b> 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 (<i>P</i> < 0.05). Total fixed OR time was only affected by ASA score (<i>P</i> = 0.02). <b><i>Conclusions:</i></b> 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.</p>\",\"PeriodicalId\":15723,\"journal\":{\"name\":\"Journal of endourology\",\"volume\":\" \",\"pages\":\"121-126\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of endourology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1089/end.2024.0330\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of endourology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/end.2024.0330","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/26 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Impact of Patient Factors on Robotic-Assisted Partial Nephrectomy Operating Room Times: The Case for Fixed Operating Room Time as a Viable Efficiency Target.
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.
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
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Endourology survey section of endourology relevant manuscripts published in other journals.