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WCE 2017: The Effect of Robotic Assistance on Outcomes for Partial Nephrectomies

Vancouver, Canada (UroToday.com) David Ali, a fourth year medical student at the Icahn School of Medicine, presented data on the potential beneficial outcomes of performing robotics-assisted partial nephrectomies (RAPN) compared to patient outcomes of laparoscopic partial nephrectomies (LPN) and open partial nephrectomies (OPN). The purpose of this study was to further analyze the advantages of RAPN while considering confounding variables such as centralization trends and other procedure, patient, and physician-level variables. 

For analysis, the research team retrospectively reviewed 11,357 PN cases ranging from 2009 to 2015 utilizing a database called the New York Statewide Planning and Research Cooperative System (SPARCS). Ali and his team additionally utilized the American Medical Association Masterfile and American Hospital Association Dataviewer to supplement each procedure with an identified urologist and information about the specific hospitals. 

The robotic approach was associated with improved outcomes in 30-day remission, 1-year mortality, and prolonged length of stay (>12 days). Overall, the results from this study indicate that the use of RAPN is correlated with a 53% reduction in the likelihood of long stays and 34% reduction in the likelihood of a 30-day readmission. 

According to the database, proportion of PN done by RAPN has continued to increase steadily between 2009-2014, concurrent with an overall increase in partial nephrectomy cases during the same time period. Ali concluded by acknowledging that future directions should explore why these benefits exist. 

Presented by: David Ali 

Authors: Mark Finkelstein, Khawaja H. Bilal, Michael A. Palese
Affiliation: Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY

Written by Taylor Capretz, Department of Urology, University of California- Irvine at the 35th World Congress of Endourology – September 12-16, 2017, Vancouver, Canada.