To define current trends in the utilization of renal thermal ablation by urologists in the United States.
6-month case log data for renal procedures submitted by certifying and recertifying American urologists from 2003 to 2018 were obtained from the American Board of Urology and stratified by Current Procedural Terminology (CPT) code. The utilization of thermal ablative techniques was examined with respect to overall trends, surgeon and practice characteristics associated with its use.
6211 unique urologists performed 54075 renal procedures including 1,916 (3.5%) thermal ablations, 630 (1.2%) renal biopsies, 17,361 (32.1%) partial nephrectomies, 20403 (37.8%) radical nephrectomies and 7957 (14.7%) nephroureterectomies. 825 (13.3%) unique urologists performed renal ablations including 1,344 (70.2%), 418 (21.8%) and 154 (8.0%) laparoscopic, percutaneous and open ablation procedures, respectively. The annual volume of ablation was highest in 2008, followed by 2010 and 2009. On multivariate modeling of those performing renal interventions, the first decade of practice, self-declared Endourologist, urologist who completed an Endourology fellowship, urologist who practices in the Mid Atlantic, North Central, South Central and South Eastern United States (Compared to New England) were more likely to perform thermal ablation for renal masses. Urologists who perform renal biopsies and partial nephrectomies are also more likely to perform ablation of renal masses.
Thermal ablation accounted for a small percentage of renal interventions performed by urologists in the last 1.5 decades with definable associations to practice characteristics. Renal ablation was most commonly performed laparoscopically, with declining use in recent years.
Journal of endourology. 2019 Dec 17 [Epub ahead of print]
Wei Phin Tan, Ariel Schulman, Gregory J Barton, Christina Sze, Thomas J Polascik
Duke University Health System, 213852, Surgery, Durham, North Carolina, United States; ., Maimonides Medical Center, 2042, Brooklyn, New York, United States; ., Duke University Health System, 213852, Surgery, Durham, North Carolina, United States; ., Duke University Health System, 213852, Surgery, Durham, North Carolina, United States; ., Duke University Medical Center, Urologic Surgery, Box 3707, Durham, North Carolina, United States, 27710; .