Robot-assisted vs. Laparoscopic Partial Nephrectomy: utilization rates and perioperative outcomes
Objectives To examine the effect of surgical approach on perioperative morbidity and mortality after partial nephrectomy. Materials and Methods Within the Nationwide Inpatient Sample, patients who underwent RAPN or LPN between October 2008 and December 2009 were identified. Propensity-based matching was performed to adjust for potential baseline differences between the two groups. The rates of intraoperative and postoperative complications, blood transfusions, prolonged length of stay, and in-hospital mortality, stratified according to RAPN vs. LPN, were compared. Results Overall, 851 (72.5%) patients underwent RAPN and 323 (27.5%) underwent LPN. For RAPN and LPN respectively, the following rates were recorded in the propensity-score matched cohort: blood transfusions, 4.5 vs. 6.8% (p = 0.223); intraoperative complications, 5.2 vs. 2.6% (p = 0.096); postoperative complications, 10.6 vs. 13.5% (p = 0.268); prolonged length of stay, 6.8 vs. 9.4% (p = 0.238); in-hospital mortality, 0.0 vs. 0.0%. Conclusions RAPN has supplanted LPN as the predominant minimally invasive surgical approach for renal masses. Perioperative outcomes after RAPN and LPN are comparable. Interpretation of these findings needs to take into account the lack of adjustment for case complexity and surgical expertise.
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Sociedade Brasileira de Urologia
2013
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oai:scielo:S1677-553820130003003772013-08-16Robot-assisted vs. Laparoscopic Partial Nephrectomy: utilization rates and perioperative outcomesSammon,Jesse D.Karakiewicz,Pierre I.Sun,MaxineRavi,PrafulGhani,Khurshid R.Jeong,WoojuBianchi,MarcoHansen,JensPerrotte,PaulPeabody,James O.Rogers,Craig G.Shariat,Shahrokh F.Menon,ManiTrinh,Quoc-Dien Nephrectomy Robotics Laparoscopy Objectives To examine the effect of surgical approach on perioperative morbidity and mortality after partial nephrectomy. Materials and Methods Within the Nationwide Inpatient Sample, patients who underwent RAPN or LPN between October 2008 and December 2009 were identified. Propensity-based matching was performed to adjust for potential baseline differences between the two groups. The rates of intraoperative and postoperative complications, blood transfusions, prolonged length of stay, and in-hospital mortality, stratified according to RAPN vs. LPN, were compared. Results Overall, 851 (72.5%) patients underwent RAPN and 323 (27.5%) underwent LPN. For RAPN and LPN respectively, the following rates were recorded in the propensity-score matched cohort: blood transfusions, 4.5 vs. 6.8% (p = 0.223); intraoperative complications, 5.2 vs. 2.6% (p = 0.096); postoperative complications, 10.6 vs. 13.5% (p = 0.268); prolonged length of stay, 6.8 vs. 9.4% (p = 0.238); in-hospital mortality, 0.0 vs. 0.0%. Conclusions RAPN has supplanted LPN as the predominant minimally invasive surgical approach for renal masses. Perioperative outcomes after RAPN and LPN are comparable. Interpretation of these findings needs to take into account the lack of adjustment for case complexity and surgical expertise. info:eu-repo/semantics/openAccessSociedade Brasileira de UrologiaInternational braz j urol v.39 n.3 20132013-06-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382013000300377en10.1590/S1677-5538.IBJU.2013.03.11 |
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Sammon,Jesse D. Karakiewicz,Pierre I. Sun,Maxine Ravi,Praful Ghani,Khurshid R. Jeong,Wooju Bianchi,Marco Hansen,Jens Perrotte,Paul Peabody,James O. Rogers,Craig G. Shariat,Shahrokh F. Menon,Mani Trinh,Quoc-Dien |
spellingShingle |
Sammon,Jesse D. Karakiewicz,Pierre I. Sun,Maxine Ravi,Praful Ghani,Khurshid R. Jeong,Wooju Bianchi,Marco Hansen,Jens Perrotte,Paul Peabody,James O. Rogers,Craig G. Shariat,Shahrokh F. Menon,Mani Trinh,Quoc-Dien Robot-assisted vs. Laparoscopic Partial Nephrectomy: utilization rates and perioperative outcomes |
author_facet |
Sammon,Jesse D. Karakiewicz,Pierre I. Sun,Maxine Ravi,Praful Ghani,Khurshid R. Jeong,Wooju Bianchi,Marco Hansen,Jens Perrotte,Paul Peabody,James O. Rogers,Craig G. Shariat,Shahrokh F. Menon,Mani Trinh,Quoc-Dien |
author_sort |
Sammon,Jesse D. |
title |
Robot-assisted vs. Laparoscopic Partial Nephrectomy: utilization rates and perioperative outcomes |
title_short |
Robot-assisted vs. Laparoscopic Partial Nephrectomy: utilization rates and perioperative outcomes |
title_full |
Robot-assisted vs. Laparoscopic Partial Nephrectomy: utilization rates and perioperative outcomes |
title_fullStr |
Robot-assisted vs. Laparoscopic Partial Nephrectomy: utilization rates and perioperative outcomes |
title_full_unstemmed |
Robot-assisted vs. Laparoscopic Partial Nephrectomy: utilization rates and perioperative outcomes |
title_sort |
robot-assisted vs. laparoscopic partial nephrectomy: utilization rates and perioperative outcomes |
description |
Objectives To examine the effect of surgical approach on perioperative morbidity and mortality after partial nephrectomy. Materials and Methods Within the Nationwide Inpatient Sample, patients who underwent RAPN or LPN between October 2008 and December 2009 were identified. Propensity-based matching was performed to adjust for potential baseline differences between the two groups. The rates of intraoperative and postoperative complications, blood transfusions, prolonged length of stay, and in-hospital mortality, stratified according to RAPN vs. LPN, were compared. Results Overall, 851 (72.5%) patients underwent RAPN and 323 (27.5%) underwent LPN. For RAPN and LPN respectively, the following rates were recorded in the propensity-score matched cohort: blood transfusions, 4.5 vs. 6.8% (p = 0.223); intraoperative complications, 5.2 vs. 2.6% (p = 0.096); postoperative complications, 10.6 vs. 13.5% (p = 0.268); prolonged length of stay, 6.8 vs. 9.4% (p = 0.238); in-hospital mortality, 0.0 vs. 0.0%. Conclusions RAPN has supplanted LPN as the predominant minimally invasive surgical approach for renal masses. Perioperative outcomes after RAPN and LPN are comparable. Interpretation of these findings needs to take into account the lack of adjustment for case complexity and surgical expertise. |
publisher |
Sociedade Brasileira de Urologia |
publishDate |
2013 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382013000300377 |
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