Contemporary National Assessment of Robot-Assisted Surgery Rates and Total Hospital Charges for Major Surgical Uro-Oncological Procedures in the United States
| Autor: | Alberto Briganti, Kevin C. Zorn, Sophie Knipper, Francesco A. Mistretta, Francesco Montorsi, Zhe Tian, Alessandro Larcher, Shahrokh F. Shariat, Elio Mazzone, Umberto Capitanio, Fred Saad, Hugues Widmer, Pierre I. Karakiewicz, Markus Graefen |
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| Přispěvatelé: | Mazzone, E., Mistretta, F. A., Knipper, S., Tian, Z., Larcher, A., Widmer, H., Zorn, K., Capitanio, U., Graefen, M., Montorsi, F., Shariat, S. F., Saad, F., Briganti, A., Karakiewicz, P. I. |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Robot assistance Adolescent Databases Factual Urology medicine.medical_treatment 030232 urology & nephrology Cystectomy Nephrectomy Young Adult 03 medical and health sciences 0302 clinical medicine Robotic Surgical Procedures nationwide inpatients sample Neoplasms nephrectomy total hospital charges medicine Humans radical cystectomy Aged Prostatectomy robot-assisted surgery business.industry General surgery Middle Aged Hospital Charges United States radical prostatectomy Hospitalization 030220 oncology & carcinogenesis Urologic Surgical Procedures Robot Female Laparoscopy business Algorithms |
| Zdroj: | Journal of Endourology. 33:438-447 |
| ISSN: | 1557-900X 0892-7790 |
| DOI: | 10.1089/end.2018.0840 |
| Popis: | Background: The role of robot assistance is increasingly gaining importance among all major surgical uro-oncological procedures (MSUPs). However, contemporary analyses showed that total hospital charges (THCGs) related to robot-assisted procedures exceed those of open procedures. Based on increasing familiarity with robot-assisted surgery, we postulated that THCGs may have decreased over the past half-decade. Thus, we tested contemporary trends and THCGs related to robot-assisted vs nonrobot-assisted MSUPs. Materials and Methods: Within the National Inpatient Sample database (2009-2015), we identified patients who underwent robot-assisted vs nonrobot-assisted (open or laparoscopic) MSUPs, which included radical prostatectomy (RP), radical nephrectomy (RN), partial nephrectomy (PN), and radical cystectomy (RC). Rates of robot-assisted MSUPs were evaluated using estimated annual percentage changes (EAPCs) analyses. The t-test was used to examine statistically significant differences between mean THCGs according to either robot-assisted or nonrobot-assisted approach. Finally, linear regression analyses were tested for annual variation in the mean THCGs. Results: Of 128,367 MSUPs, 47.7% were robot-assisted. Overall, robot-assisted surgery rates among MSUPs increased from 40.3% to 57.6% (EAPC: +6.3%, p < 0.001) between 2009 and 2015. The mean THCGs for robot-assisted RP, RN, PN, and RC were $13,799, $18,789, $16,574, and $33,575, respectively. The observed mean THCGs differences between robot-assisted and nonrobot-assisted MSUPs were +$1594, +$1592, and +$1829 for RP, RN, and RC, respectively (all p < 0.05). Conversely, no statistically significant difference in the mean THCGs was reported between robot-assisted and nonrobot-assisted PN (+$367, p > 0.05). Finally, the annual observed mean THCGs linearly decreased for all robot-assisted MSUPs during the study period. Conclusions: Rates of robot-assisted MSUPs exponentially increased between 2009 and 2015. Although the mean THCGs decreased in a significant manner during the study period for all MSUPs, THCGs of robot-assisted RP, RN, and RC still exceed those of their respective nonrobot-assisted counterparts. Conversely, no differences in the mean THCGs were reported between robot-assisted vs nonrobot-assisted PN. |
| Databáze: | OpenAIRE |
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