The learning curve of a surgical care practitioner performing local anaesthetic transperineal prostate biopsies: Cancer rate detection and complications

2020 ◽  
Vol 14 (3) ◽  
pp. 133-133
Author(s):  
Beatriz Mora Lucas
Keyword(s):  
Learning Curve ◽  
Local Anaesthetic ◽  
Surgical Care ◽  
Cancer Rate ◽  
Prostate Biopsies

Complications following local anaesthetic transperineal prostate biopsies without antibiotic prophylaxis: An institution’s experience

2021 ◽  
pp. 205141582098766
Author(s):  
Joseph B John ◽  
Angus MacCormick ◽  
Ruaraidh MacDonagh ◽  
Mark J Speakman ◽  
Ramesh Vennam ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Local Anaesthetic ◽  
Complication Rate ◽  
Admission Rate ◽  
Prophylactic Antibiotics ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Hospital Admission Rate ◽  
Prostate Biopsies ◽  
Disease Characteristics

Objectives: This study aimed to describe a UK institution’s experience with local anaesthetic (LA) transperineal (TP) prostate biopsies (PB), and to report 30-day complications following LATPPB, including a large cohort that did not receive antibiotic prophylaxis. Patients and methods: A prospective database of 313 consecutive patients undergoing LATPPB was maintained, describing patient and disease characteristics, and complications. From September 2019 to January 2020, antibiotic prophylaxis was given before LATPPB ( n=149). Following a change to routine care, from January 2020 to July 2020, prophylactic antibiotics were not given before LATPPB ( n=164). A comparative analysis was performed to determine complication rates following antibiotic prophylaxis discontinuation using electronic hospital and primary care records. Results: Patient and disease characteristics were comparable in antibiotic and non-antibiotic cohorts, and representative of PB and prostate cancer cohorts described in the urological literature. The infection-related complication rate was 0.32% across all patients, and 0% for those not receiving antibiotic prophylaxis. The overall complication rate was 0.64%, and 0.61% for those not receiving antibiotic prophylaxis. There were no severe (Clavien–Dindo 3–5) complications. The unplanned hospital admission rate was 0.64%. Conclusion: The complication rate after LATPPB was low, with no infection-related complications in patients who did not receive antibiotic prophylaxis. This provides further evidence supporting the discontinuation of routine prophylactic antibiotics before TPPB. Level of evidence: Level 2b.

The Provision of Acute Pediatric Surgical Care by Adult Acute Care General Surgeons

2020 ◽  
pp. 000313482093325
Author(s):  
Chelsea M. Knotts ◽  
Edward J. Prange ◽  
Krysta Orminski ◽  
Stephanie Thompson ◽  
Bryan K. Richmond
Keyword(s):  
Learning Curve ◽  
Acute Care ◽  
Pediatric Patients ◽  
Surgical Care ◽  
Comfort Level ◽  
General Surgeon ◽  
Published Data ◽  
Common Procedure ◽  
General Surgeons ◽  
Pediatric Laparoscopy

Background At our hospital, acute surgical care of children aged 6 and older is managed by adult acute care surgeons. Previously published data from a 10-year experience with this model demonstrated no differences in outcomes when compared with pediatric surgical benchmark data. This study assesses for the effects of a learning curve in the care of pediatric patients by comparing outcomes of patients treated in the first three years with those treated in the last 3 years during a 10-year experience with this model. Design This was a retrospective study of pediatric patients aged 6 and older who underwent an emergent or urgent, nontrauma surgical procedure by a general surgeon. Data was obtained via chart review and descriptive statistics were compared between patients operated on between January 1, 2009-January 1, 2012 and January 1, 2016-January 1, 2019. Results In all, 208 cases were performed in the early cohort and 192 cases in the late cohort. Appendectomy was the most common procedure in both intervals (88% early, 94.8% late). Although there was a significant decrease in open procedures in the later cohort (22.6% vs 4.7%, P < .001), there was no significant change in disease-specific complications or negative appendectomies. No consults to a fellowship-trained pediatric surgeon were required during either time period, although one was available if needed. Conclusions Our data demonstrated a decrease in the number of open procedures in the later cohort. This may be due to an increased comfort level with pediatric laparoscopy over time. However, no significant changes in outcomes were observed. This study supports that acute care general surgeons can provide comparable care to pediatric patients within this age demographic and that although a learning curve, appears to exist with respect to pediatric laparoscopy, it is insignificant in terms of its effect on overall outcomes.

scholarly journals MP34-16 SWITCHING FROM SEDATION TO LOCAL ANAESTHETIC TRANSPERINEAL PROSTATE BIOPSIES: A COST-BENEFIT ANALYSIS

2021 ◽  
Vol 206 (Supplement 3) ◽  
Author(s):  
Uma Walters ◽  
Martin J Connor ◽  
Edward J Bass ◽  
David Eldred-Evans ◽  
William Maynard ◽  
...  
Keyword(s):  
Local Anaesthetic ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Prostate Biopsies

The Learning Curve of Transrectal Ultrasound-guided Prostate Biopsies: Implications for Training Programs

Urology ◽  
2013 ◽  
Vol 81 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Amine Benchikh El Fegoun ◽  
Rabii El Atat ◽  
Laurence Choudat ◽  
Elie El Helou ◽  
Jean-François Hermieu ◽  
...  
Keyword(s):  
Learning Curve ◽  
Training Programs ◽  
Transrectal Ultrasound ◽  
Ultrasound Guided ◽  
Prostate Biopsies

Characterizing the learning curve of MRI-US fusion prostate biopsies

2019 ◽  
Vol 22 (4) ◽  
pp. 546-551 ◽  
Author(s):  
Daniel Halstuch ◽  
Jack Baniel ◽  
David Lifshitz ◽  
Sivan Sela ◽  
Yaara Ber ◽  
...  
Keyword(s):  
Learning Curve ◽  
Prostate Biopsies

scholarly journals Economic Evaluation of Transperineal versus Transrectal Devices for Local Anaesthetic Prostate Biopsies

2021 ◽  
Author(s):  
Edward C. F. Wilson ◽  
Alice Wreford ◽  
Priya Tamer ◽  
Kelly Leonard ◽  
Hannah Brechka ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Local Anaesthetic ◽  
Prostate Biopsies

Comparing tolerability of local anaesthetic transperineal and transrectal prostate biopsies

2021 ◽  
pp. 205141582110240
Author(s):  
Benjamin Starmer ◽  
Nic Iordan ◽  
John McCabe
Keyword(s):  
Visual Analogue Scale ◽  
Local Anaesthetic ◽  
Analogue Scale ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Level Of Evidence ◽  
Prostate Biopsies ◽  
Transrectal Biopsy ◽  
Scale Scores ◽  
Transperineal Biopsy

Objectives: Local anaesthetic transperineal prostate biopsies have been demonstrated as tolerable. However, to date, the tolerability has not been directly compared to the standard of care for transrectal biopsy. We set out to prospectively compare the tolerability of local anaesthetic transperineal and transrectal prostate biopsies. Patients and methods: All patients between 3 April 2019 to 6 December 2019 undergoing local anaesthetic transperineal / transrectal ultrasound biopsy were prospectively asked to complete a questionnaire using visual analogue scales assessing the tolerability of their biopsy. Results: 108 patients were included. Baseline characteristics (mean): age 66.4 years, prostate-specific antigen 13.7 ng/dl, prostate volume 48 ml. Of the patients 51% had ⩾ Gleason 3+4 prostate cancer. 56 patients had transperineal and 52 patients had transrectal biopsy. Median visual analogue scale scores (0–9: transperineal vs transrectal) for probe insertion, probe presence, local anaesthetic injection and taking biopsy were 3 vs 4 ( p=0.66), 3 vs 3 ( p=0.91), 3 vs 2 ( p=0.15) and 3 vs 3 ( p=0.18), respectively. Median visual analogue scale scores (0–3) for overall pain, embarrassment and how they would describe it to a friend were 1 vs 1 ( p=0.17), 0 vs 0 ( p=0.34) and 1 vs 1 ( p=0.2), respectively (transperineal vs transrectal ultrasound). 42 of the 56 patients in the transperineal group had prior transrectal biopsy. 24/42 patients described local anaesthetic transperineal biopsy as the same or better than transrectal; 15/42 described it as a little worse. Conclusion: Tolerability of local anaesthetic transperineal biopsy is comparable to transrectal biopsy. As such, we advocate the routine use of transperineal biopsy and to phase out the transrectal approach where possible. Level of evidence: 2b

scholarly journals PD23-08 CHARACTERIZING THE LEARNING CURVE OF MRI-US FUSION PROSTATE BIOPSIES

2018 ◽  
Vol 199 (4S) ◽  
Author(s):  
David Margel ◽  
Yaara Ber ◽  
Sivan Sela ◽  
Tzlil Tabachnik ◽  
Ira Belo ◽  
...  
Keyword(s):  
Learning Curve ◽  
Prostate Biopsies
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