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<p>To evaluate the impact of teaching during radical prostatectomy in a nationwide prospective registry, assessing whether teaching influences perioperative or pathological outcomes. Data were extracted from the Swiss Urology Prostatectomy Registry, a nationwide quality-monitoring program including all certified training centers. Teaching was defined as procedures performed by a supervised trainee as primary operator. Baseline and perioperative outcomes were compared descriptively, and multivariable regression models assessed associations between teaching status and perioperative and pathological outcomes. A total of 7,607 men underwent radical prostatectomy between 2020 and 2025, of whom 825 (10.8%) were teaching cases. In multivariable analyses, teaching operations were associated with a higher likelihood of any 30-day complication (OR 1.41; 95% CI 1.09–1.82; <i>p</i> = 0.008) and longer operative time, with an adjusted mean increase of 31&#xa0;min (95% CI 26–37; <i>p</i> &lt; 0.001). Teaching status was not associated with severe complications (Clavien–Dindo ≥ III; OR 0.62; 95% CI 0.24–1.36; <i>p</i> = 0.283), transfusion requirement (OR 1.56; 95% CI 0.36–4.60; <i>p</i> = 0.478), positive surgical margins (OR 0.99; 95% CI 0.81–1.22; <i>p</i> = 0.960), nerve-sparing (OR 1.12; 95% CI 0.90–1.39; <i>p</i> = 0.306), or lymph node yield (adjusted mean difference + 0.5 nodes; 95% CI − 0.3 to 1.4; <i>p</i> = 0.226). Teaching during radical prostatectomy is safe and does not compromise surgical or pathological outcomes. Although longer operative times were observed, supervised trainee involvement can be safely integrated into structured training programs.</p>

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Teaching in radical prostatectomy is safe: a multicenter prospective registry analysis

  • 期刊论文

  • 发表日期：

    2026年3月30日

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  • Nicola Giudici,
  • Raphael Röthlisberger,
  • Nicolas Arnold,
  • Daniel Phat Nguyen,
  • Agostino Mattei,
  • Massimo Valerio,
  • Daniel Eberli,
  • Dominik Abt,
  • Räto Strebel,
  • Daniel Engeler,
  • George Thalmann,
  • Laila Schneidewind,
  • Beat Roth

摘要

To evaluate the impact of teaching during radical prostatectomy in a nationwide prospective registry, assessing whether teaching influences perioperative or pathological outcomes. Data were extracted from the Swiss Urology Prostatectomy Registry, a nationwide quality-monitoring program including all certified training centers. Teaching was defined as procedures performed by a supervised trainee as primary operator. Baseline and perioperative outcomes were compared descriptively, and multivariable regression models assessed associations between teaching status and perioperative and pathological outcomes. A total of 7,607 men underwent radical prostatectomy between 2020 and 2025, of whom 825 (10.8%) were teaching cases. In multivariable analyses, teaching operations were associated with a higher likelihood of any 30-day complication (OR 1.41; 95% CI 1.09–1.82; p = 0.008) and longer operative time, with an adjusted mean increase of 31 min (95% CI 26–37; p < 0.001). Teaching status was not associated with severe complications (Clavien–Dindo ≥ III; OR 0.62; 95% CI 0.24–1.36; p = 0.283), transfusion requirement (OR 1.56; 95% CI 0.36–4.60; p = 0.478), positive surgical margins (OR 0.99; 95% CI 0.81–1.22; p = 0.960), nerve-sparing (OR 1.12; 95% CI 0.90–1.39; p = 0.306), or lymph node yield (adjusted mean difference + 0.5 nodes; 95% CI − 0.3 to 1.4; p = 0.226). Teaching during radical prostatectomy is safe and does not compromise surgical or pathological outcomes. Although longer operative times were observed, supervised trainee involvement can be safely integrated into structured training programs.