Radical perineal prostatectomy: a learning curve?

To determine a learning curve for radical perineal prostatectomy after formal training in radical retropubic prostatectomy. Using the William Beaumont Hospital Prostatectomy database, we analyzed peri-operative data from two surgeons performing radical perineal prostatectomies from their initial 96 cases to determine a learning curve. Over time, data between the first and last quarters showed consistent, excellent results in terms of skin time (143 SD +/- 22 and 136 SD +/- 24 min), blood loss (310 SD +/- 120 and 335 +/- 216 cc), and length of stay (1.3 SD +/- 0.6 and 1.2 SD +/- 0.5 days), without significant change. However, only two positive margins were obtained in the 4th quartile representing a significant change and possibly representing a learning curve. These data show that excellent, reproducible results can be obtained using basic surgical principles, without incorporating expensive technology and resources.