Surgical expertise reduces transfusion need in prostate cancer surgery
Individual surgeons’ expertise in performing prostate cancer surgery is the predominant factor in determining whether a patient will require blood transfusions
Date: 8/24/2004
BIDMC Contact: Jerry Berger
Phone: 617-667-7308
BOSTON – Individual surgeons’ expertise in performing prostate cancer surgery is the predominant factor in determining whether a patient will require blood transfusions, according to a study published in the current issue of the journal Urology.
Although size of the prostate, the type of anesthesia and use of hormonal therapy prior to surgery also play a role in determining the likelihood of a transfusion, the study found sharply reduced transfusion rates in cases performed by surgeons who did more than 15 radical prostatectomies annually, according to Martin Sanda, M.D., director of the Prostate Cancer Care Center at Beth Israel Deaconess Medical Center and senior author of the study conducted in conjunction with the University of Michigan.
“This study revealed that the amount of bleeding and consequent requirement for transfusion during prostate surgery differs markedly between surgeons,” says Sanda. “This is significant because many patients and their primary care doctors may not realize that they should inquire about surgeons’ transfusion rates, as such information is readily available at most hospitals.”
The study shows that transfusion rates are a benchmark of prostate cancer care quality that not only varies widely between prostate surgeons, but that could also be readily available to patients, as transfusion data can be readily monitored by health care providers and hospitals. Of interest, one of the factors affecting bleeding was the type of anesthesia used during surgery.
“Our findings also reconfirm that epidural anesthesia is associated with less bleeding during prostate surgery, yet few surgeons use epidural anesthesia for prostatectomy,” added Sanda. “Our hope is that these findings will help surgeons and hospitals adopt improved techniques (such as using epidural anesthesia for prostatectomy) and thereby elevate prostate cancer surgery outcomes to the highest common denominator.”
Beth Israel Deaconess Medical Center is a major patient care, teaching and research affiliate of Harvard Medical School, and ranks third in National Institutes of Health funding among independent hospitals nationwide. BIDMC is clinically affiliated with the Joslin Diabetes Center and is a research partner of Dana-Farber/Harvard Cancer Center. BIDMC is the official hospital of the Boston Red Sox. For more information, visit www.bidmc.harvard.edu.
