Practice Patterns and Outcomes of Open and Minimally Invasive Partial Nephrectomy Since the Introduction of Robotic Partial Nephrectomy: Results from the Nationwide Inpatient Sample

No AccessJournal of UrologyAdult Urology1 Apr 2014Practice Patterns and Outcomes of Open and Minimally Invasive Partial Nephrectomy Since the Introduction of Robotic Partial Nephrectomy: Results from the Nationwide Inpatient Sample Khurshid R. Ghani, Shyam Sukumar, Jesse D. Sammon, Craig G. Rogers, Quoc-Dien Trinh, and Mani Menon Khurshid R. GhaniKhurshid R. Ghani Department of Urology, University of Michigan, Ann Arbor, Michigan Equal study contribution. More articles by this author , Shyam SukumarShyam Sukumar Department of Urology, University of Minnesota, Minneapolis, Minnesota Equal study contribution. More articles by this author , Jesse D. SammonJesse D. Sammon Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan More articles by this author , Craig G. RogersCraig G. Rogers Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan Financial interest and/or other relationship with Intuitive Surgical. More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh Department of Surgery, Division of Urology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts Financial interest and/or other relationship with Intuitive Surgical. More articles by this author , and Mani MenonMani Menon Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.10.099AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail 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. 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Volume 191Issue 4April 2014Page: 907-913Supplementary Materials Advertisement Copyright & Permissions© 2014 by American Urological Association Education and Research, Inc.KeywordsnephrectomyroboticslaparoscopycomplicationskidneyMetricsAuthor Information Khurshid R. Ghani Department of Urology, University of Michigan, Ann Arbor, Michigan Equal study contribution. More articles by this author Shyam Sukumar Department of Urology, University of Minnesota, Minneapolis, Minnesota Equal study contribution. More articles by this author Jesse D. Sammon Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan More articles by this author Craig G. Rogers Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan Financial interest and/or other relationship with Intuitive Surgical. More articles by this author Quoc-Dien Trinh Department of Surgery, Division of Urology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts Financial interest and/or other relationship with Intuitive Surgical. More articles by this author Mani Menon Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan More articles by this author Expand All Advertisement PDF downloadLoading ...