Hospital costs and length of stay related to robot-assisted versus open radical and partial nephrectomy for kidney cancer in the USA
- 187 Downloads
There are scant national outcomes data for robot-assisted laparoscopic surgery. We assessed costs and length of stay (LOS) related to robot-assisted radical and partial nephrectomy in a nationally representative population database. We performed a cohort analysis of the US Nationwide Inpatient Sample database. Using ICD-9 procedure codes, we identified patients who underwent radical or partial nephrectomy for kidney cancer from October 2008 to December 2008. We excluded patients with non-robot-assisted laparoscopic procedures and those under age 18 years. We performed multivariate analyses of LOS and total hospital charges, adjusting for age, race, gender, Charlson comorbidity index, and teaching hospital status. Records of 2,242 patients were analyzed. On adjusted multivariate analysis, robot-assisted partial nephrectomy was associated with shorter LOS compared with open surgery (−2.0 days, P = 0.032). Robot-assisted radical nephrectomy was associated with shorter LOS compared with open surgery (−1.8 days, P = 0.077). There were no significant differences in total charges for robot-assisted compared with open surgery for either radical (P = 0.631) or partial (P = 0.713) nephrectomy. In this large, population-based analysis, robot-assisted radical and partial nephrectomy were associated with shorter LOS and equivalent hospital charges compared with their open surgery counterparts. These data suggest that, for renal surgery, diminished LOS offsets other hospital costs associated with robot-assisted procedures.
KeywordsRobotic Nephrectomy Laparoscopy Renal cell carcinoma Partial Outcomes
- 7.Permpongkosol S, Bagga HS, Romero FR, Sroka M, Jarrett TW, Kavoussi LR (2006) Laparoscopic versus open partial nephrectomy for the treatment of pathological T1N0M0 renal cell carcinoma: a 5-year survival rate. J Urol 176:1984–1988 (discussion 1988–1989)Google Scholar
- 8.Pierorazio PM, Patel HD, Feng T, Yohannan J, Hyams ES, Allaf ME (2011) Robot-assisted versus traditional laparoscopic partial nephrectomy: comparison of outcomes and evaluation of learning curve. Urology 78(4):813–819. doi:10.1016/j.urology.2011.04.065; Epub ahead of printPubMedCrossRefGoogle Scholar
- 10.Agency for Healthcare Research and Quality. Overview of the nationwide inpatient sample (NIS). http://www.hcup-us.ahrq.gov/nisoverview.jsp. Accessed March 2 2011
- 12.Romano PS, Roos LL, Jollis JG (1993) Adapting a clinical comorbidity index for use with ICD-9-CM administrative data: differing perspectives. J Clin Epidemiol 46:1075–1079 (discussion 1081–1090)Google Scholar