Khurshid R Ghani1, Shyam Sukumar2, Jesse D Sammon3, Craig G Rogers3, Quoc-Dien Trinh4, Mani Menon3. 1. Department of Urology, University of Michigan, Ann Arbor, Michigan. Electronic address: kghani@med.umich.edu. 2. Department of Urology, University of Minnesota, Minneapolis, Minnesota. 3. Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan. 4. Department of Surgery, Division of Urology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
Abstract
PURPOSE: We determined practice patterns and perioperative outcomes of open and minimally invasive partial nephrectomy in the United States since the introduction of a robot-assisted modifier in the Nationwide Inpatient Sample. MATERIALS AND METHODS: We identified all patients with nonmetastatic disease treated with open, laparoscopic or robotic partial nephrectomy in the Nationwide Inpatient Sample between October 2008 and December 2010. Utilization rates were assessed by year, patient and hospital characteristics. We evaluated the perioperative outcomes of open vs robotic and open vs laparoscopic partial nephrectomy using binary logistic regression models adjusted for patient and hospital covariates. RESULTS: In a weighted sample of 38,064 partial nephrectomies 66.9%, 23.9% and 9.2% of the procedures were open, robotic and laparoscopic operations, respectively. In 2010 the relative annual increase in open, robotic and laparoscopic partial nephrectomy was 7.9%, 45.4% and 6.1%, respectively. Compared to open partial nephrectomy patients treated with minimally invasive partial nephrectomy were less likely to receive blood transfusion (robotic vs laparoscopic OR 0.56, p <0.001 vs OR 0.68, p = 0.016), postoperative complication (OR 0.63, p <0.001 vs OR 0.78, p <0.009) or prolonged length of stay (OR 0.27 vs OR 0.41, each p <0.001). Only patients who underwent the robotic procedure were less likely to experience an intraoperative complication (robotic vs laparoscopic OR 0.69, p = 0.014 vs OR 0.67, p = 0.069). Excess hospital charges were higher after robotic surgery (OR 1.35, p <0.001). CONCLUSIONS: The dissemination of robotic surgery for partial nephrectomy in the United States has been rapid and safe. Compared to open partial nephrectomy the robotic procedure had lower odds than laparoscopic partial nephrectomy for most study outcomes except hospital charges. Robotic partial nephrectomy has now supplanted laparoscopic partial nephrectomy as the most common minimally invasive approach for partial nephrectomy.
PURPOSE: We determined practice patterns and perioperative outcomes of open and minimally invasive partial nephrectomy in the United States since the introduction of a robot-assisted modifier in the Nationwide Inpatient Sample. MATERIALS AND METHODS: We identified all patients with nonmetastatic disease treated with open, laparoscopic or robotic partial nephrectomy in the Nationwide Inpatient Sample between October 2008 and December 2010. Utilization rates were assessed by year, patient and hospital characteristics. We evaluated the perioperative outcomes of open vs robotic and open vs laparoscopic partial nephrectomy using binary logistic regression models adjusted for patient and hospital covariates. RESULTS: In a weighted sample of 38,064 partial nephrectomies 66.9%, 23.9% and 9.2% of the procedures were open, robotic and laparoscopic operations, respectively. In 2010 the relative annual increase in open, robotic and laparoscopic partial nephrectomy was 7.9%, 45.4% and 6.1%, respectively. Compared to open partial nephrectomy patients treated with minimally invasive partial nephrectomy were less likely to receive blood transfusion (robotic vs laparoscopic OR 0.56, p <0.001 vs OR 0.68, p = 0.016), postoperative complication (OR 0.63, p <0.001 vs OR 0.78, p <0.009) or prolonged length of stay (OR 0.27 vs OR 0.41, each p <0.001). Only patients who underwent the robotic procedure were less likely to experience an intraoperative complication (robotic vs laparoscopic OR 0.69, p = 0.014 vs OR 0.67, p = 0.069). Excess hospital charges were higher after robotic surgery (OR 1.35, p <0.001). CONCLUSIONS: The dissemination of robotic surgery for partial nephrectomy in the United States has been rapid and safe. Compared to open partial nephrectomy the robotic procedure had lower odds than laparoscopic partial nephrectomy for most study outcomes except hospital charges. Robotic partial nephrectomy has now supplanted laparoscopic partial nephrectomy as the most common minimally invasive approach for partial nephrectomy.
Authors: Kevin M Curtiss; Mark W Ball; Michael A Gorin; Kelly T Harris; Phillip M Pierorazio; Mohamad E Allaf Journal: J Endourol Date: 2014-07-31 Impact factor: 2.942
Authors: Jean V Joseph; Ralph Brasacchio; Chunkit Fung; Jay Reeder; Kevin Bylund; Deepak Sahasrabudhe; Shu Yuan Yeh; Ahmed Ghazi; Patrick Fultz; Deborah Rubens; Guan Wu; Eric Singer; Edward Schwarz; Supriya Mohile; James Mohler; Dan Theodorescu; Yi Fen Lee; Paul Okunieff; David McConkey; Hani Rashid; Chawnshang Chang; Yves Fradet; Khurshid Guru; Janet Kukreja; Gerald Sufrin; Yair Lotan; Howard Bailey; Katia Noyes; Seymour Schwartz; Kathy Rideout; Gennady Bratslavsky; Steven C Campbell; Ithaar Derweesh; Per-Anders Abrahamsson; Mark Soloway; Leonard Gomella; Dragan Golijanin; Robert Svatek; Thomas Frye; Seth Lerner; Ganesh Palapattu; George Wilding; Michael Droller; Donald Trump Journal: Bladder Cancer Date: 2018-10-03
Authors: Robert H Blackwell; Anai N Kothari; Arpeet Shah; William Gange; Marcus L Quek; Fred A Luchette; Robert C Flanigan; Paul C Kuo; Gopal N Gupta Journal: Curr Urol Date: 2018-03-30
Authors: Anthony Yang; Naman Barman; Edward Chin; Daniel Herron; Antonios Arvelakis; Dianne LaPointe Rudow; Sander S Florman; Michael A Palese Journal: J Robot Surg Date: 2017-08-31
Authors: Akshay Sood; Firas Abdollah; Jesse D Sammon; Victor Kapoor; Craig G Rogers; Wooju Jeong; Dane E Klett; Julian Hanske; Christian P Meyer; James O Peabody; Mani Menon; Quoc-Dien Trinh Journal: World J Urol Date: 2015-04-25 Impact factor: 4.226
Authors: Yash S Khandwala; In Gab Jeong; Deok Hyun Han; Jae Heon Kim; Shufeng Li; Ye Wang; Steven L Chang; Benjamin I Chung Journal: Int Urol Nephrol Date: 2017-08-29 Impact factor: 2.370