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Barkati N, Ntefeh N, Okasha A, Takshe AA, ElKhatib R, Chelli S. Robotic assisted surgery in the United Arab Emirates: healthcare experts' perceptions. J Robot Surg 2023; 17:2799-2806. [PMID: 37733210 PMCID: PMC10678779 DOI: 10.1007/s11701-023-01716-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/02/2023] [Indexed: 09/22/2023]
Abstract
The adoption of Robotic Assisted Surgery (RAS) has grown around the world. This is also the case in the Middle East and Gulf region and specifically to the United Arab Emirates (UAE). The perception of RAS has been studied in the USA, Europe, and Canada. However, there is limited research on the perception of RAS in the UAE. The study aims to examine the perception of RAS among healthcare experts in the UAE and potential challenges. This qualitative study is based on interviewing healthcare experts in the UAE. Most of the study participants were clinicians and surgeons. In the UAE, RAS is adopted in general surgery, urology, brain surgery, and obstetrics and gynecology. Our findings show that healthcare experts have positive perceptions of RAS. The cost and lack of RAS training program are considered as challenges to adopting RAS in healthcare practices. More research is encouraged to examine perception variations with surgical practices in the UAE, Gulf and the Middle East.
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Affiliation(s)
- Nasim Barkati
- Department of Public Health, Canadian University Dubai, Dubai, United Arab Emirates
| | - Noura Ntefeh
- Department of Public Health, Canadian University Dubai, Dubai, United Arab Emirates
| | - Ahmad Okasha
- Department of Public Health, Canadian University Dubai, Dubai, United Arab Emirates
| | - Aseel A Takshe
- Department of Public Health, Canadian University Dubai, Dubai, United Arab Emirates.
| | - Rami ElKhatib
- Department of Public Health, Canadian University Dubai, Dubai, United Arab Emirates
| | - Sabrina Chelli
- Department of Public Health, Canadian University Dubai, Dubai, United Arab Emirates
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Awad MA, Hallgarth L, Barayan GA, Shahait M, Abu-Hijlih R, Farkouh A, Azhar RA, Alghamdi MM, Bugis A, Yaiesh S, Aldousari S, Barham A, Saed M, Moussa A, Hassen W, Naud S, Plante MK, Grunert R. Creation and validation of the harmonized Arabic version of the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP). Arab J Urol 2021; 20:88-93. [PMID: 35530568 PMCID: PMC9067989 DOI: 10.1080/2090598x.2021.2002636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives Tocreate and validate a translated Arabic version of the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP), a validated patient-reported outcome (PRO) widely used for assessing the quality of life in patients with prostate cancer (PCa). Patients and Methods Using the established protocol as defined by the Professional Society for the Health Economics and Outcomes Research (ISPOR) for translating patient care questionnaires, a harmonised translated Arabic version of EPIC-CP was created. The questionnaire was tested in native Arabic speakers from four different Arabic countries (Saudi Arabia, United Arab Emirates, Jordan, and Kuwait). Cronbach’s alpha and interclass coefficient correlation (ICC) analyses were used to test the internal consistency and test–retest reliability, respectively. In addition, PCa characteristics were collected for participants. Results In total, 168 patients with PCa participated in the study (39 from Saudi Arabia, 23 from United Arab Emirates, 65 from Jordan, and 41 from Kuwait). In all, 52 (31%) participants repeated the questionnaire for test–retest reliability analysis. The median (interquartile range [IQR]) age of patients included in the study was 66 (61–71) years. The median (IQR) PSA level was 9.8 (6–19) ng/mL. Most patients had Grade Group 2 PCa at diagnosis (31%), clinical stage cT1 (42%), managed primarily by urology (79%), and the primary treatment was radical prostatectomy (71%). The total Cronbach’s alpha coefficient was 0.84 demonstrating an acceptable internal consistency. The total ICC was also acceptable at 0.64. Conclusion The Arabic version of the EPIC-CP is a reliable and valid tool for assessing health-related quality of life for Arabic patients with PCa.
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Affiliation(s)
- Mohannad A. Awad
- Department of Surgery, Division of Urology, University of Vermont Medical Center, Burlington, VT, USA
- Department of Surgery, King Abdulaziz University, Rabigh, Saudi Arabia
| | - Luke Hallgarth
- Department of Surgery, Division of Urology, University of Vermont Medical Center, Burlington, VT, USA
| | - Ghassan A. Barayan
- Department of Surgery, Division of Urology, University of Vermont Medical Center, Burlington, VT, USA
- Department of Surgery, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohammed Shahait
- Department of Surgery, King Hussein Cancer Center, Amman, Jordan
| | - Ramiz Abu-Hijlih
- Department of Surgery, King Hussein Cancer Center, Amman, Jordan
| | - Ala’a Farkouh
- Department of Surgery, King Hussein Cancer Center, Amman, Jordan
| | - Raed A. Azhar
- Department of Surgery, Division of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Musab M. Alghamdi
- Department of Surgery, Division of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmad Bugis
- Department of Surgery, Division of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Said Yaiesh
- Urology Unit, Department of Surgery, Mubarak Al-Kabeer Hospital, Kuwait, Kuwait
| | - Saad Aldousari
- Department of Surgery (Urology Division), Faculty of Medicine, Kuwait University, Kuwait, Kuwait
- Department of Urology, MD Anderson Cancer Center, Houston, TX, USA
| | - Alaeddin Barham
- Urology, Surgical Subspecialties Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Mohamed Saed
- Urology, Surgical Subspecialties Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Ayman Moussa
- Urology, Surgical Subspecialties Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Waleed Hassen
- Urology, Surgical Subspecialties Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
- Cleveland Clinic Lerner College of Medicine of Case Western University, Cleveland, OH, USA
| | - Shelly Naud
- Medical Biostatistics, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Mark K. Plante
- Department of Surgery, Division of Urology, University of Vermont Medical Center, Burlington, VT, USA
| | - Richard Grunert
- Department of Surgery, Division of Urology, University of Vermont Medical Center, Burlington, VT, USA
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Labban M, Bulbul M, Wazzan W, Khauli R, El Hajj A. Robot-assisted radical prostatectomy in the Middle East: A report on the perioperative outcomes from a tertiary care centre in Lebanon. Arab J Urol 2020; 19:152-158. [PMID: 34104490 PMCID: PMC8158259 DOI: 10.1080/2090598x.2020.1814184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective To report on the surgical, oncological and early functional outcomes of robot-assisted radical prostatectomy (RARP) at our tertiary care centre, as there is a scarcity of reports on outcomes of robotic surgery from the Middle East. Patients and methods We reviewed the electronic health records for patients undergoing RARP between 2013 and 2019 at the American University of Beirut Medical Center. We collected patients’ demographics and preoperative oncological factors including prostate-specific antigen (PSA), clinical oncological stage, and World Health Organization (WHO) grade. PSA persistence, biochemical recurrence (BCR) and positive surgical margin (PSM) were reported. Complications were categorised by Clavien–Dindo grade. Moreover, the postoperative oncological outcomes including the rates of adjuvant and salvage androgen-deprivation therapy (ADT) and external-beam radiation therapy (EBRT), chemotherapy, and metastasis were reported. Additionally continence and potency results were retrieved. Results For the designated period, 250 patients underwent RARP of which 182 (72.8%) underwent lymph node dissection. The median (interquartile range) anaesthesia time was 330 (285–371) min and the estimated blood loss was 200 (200–300) mL. The overall complication rate was 8%, with 2% Clavien–Dindo Grade III–IV complications. The PSM and BCR rates were 21.6% and 6.4%, respectively. Adjuvant ADT and EBRT was administered to 7.2% of the patients. Functional data was available for 112 patients. Continence was 68%, 82% and 97% of the patients at 3, 6 and 12 months, respectively. For 65 patients who had bilateral nerve sparing potency was 37%, 60% and 83% at 3, 6 and 12 months, respectively. Conclusion This is the largest RARP series from the Middle East. The surgical, oncological and functional outcomes are consistent with those published in the literature. This confirms the safety and efficacy of applying robotic technology in our region during the implementation phase. Abbreviations: ADT: androgen-deprivation therapy; AJCC: American Joint Committee on Cancer; AUBMC: American University of Beirut Medical Center; BCR: biochemical recurrence; CPT: Current Procedural Terminology; EBRT external beam radiation therapy; IQR, interquartile ranges; LOS: length of stay; PLND: pelvic lymph node dissection; PSM: positive surgical margin; (O)(RA)RP, (open) (robot-assisted) radical prostatectomy
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Affiliation(s)
- Muhieddine Labban
- Division of Urology, Department of Surgery, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Muhammad Bulbul
- Division of Urology, Department of Surgery, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Wassim Wazzan
- Division of Urology, Department of Surgery, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Raja Khauli
- Division of Urology, Department of Surgery, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Albert El Hajj
- Division of Urology, Department of Surgery, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
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