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Objective <p>The aim of this work is to quantify the magnitude of improvement in in-hospital outcomes between historical and contemporary robot-assisted partial nephrectomy (RPN) versus historical and contemporary open PN (OPN).</p> Methods <p>Within the Nationwide Inpatient Sample (2010–2019), we identified patients who underwent RPN and OPN. Multivariable logistic regression models were fit.</p> Results <p>Historical (2010–2014) versus contemporary (2015–2019) proportions were 39% (<i>n </i>= 5,897) versus 61% (<i>n </i>= 9168) for RPN and 59% (<i>n </i>= 7289) versus 41% (<i>n </i>= 5,120) for OPN. Relative to historical, contemporary RPN patients exhibited significantly better in-hospital outcomes in 6 of 12 categories that ranged from−76% for intraoperative complications to−24% for length of stay (LOS) ≥ 75th percentile. Relative to historical, contemporary OPN patients also exhibited significantly better in-hospital outcomes in 7 of 12 categories that ranged from−76% for intraoperative complications to−23% for LOS ≥ 75th percentile. When historical RPN was compared with historical OPN, RPN in-hospital outcomes were better in 10 of 12 comparisons that ranged from−75% for LOS ≥ 75th percentile to−28% for perioperative bleeding. Similarly, when contemporary RPN was compared with contemporary OPN, RPN outcomes were better in 8 of 12 comparisons that ranged from−75% for LOS ≥ 75th percentile to−27% for postoperative complications.</p> Conclusion <p>The magnitude of improvement in in-hospital outcomes was more pronounced for contemporary versus historical OPN (seven improved categories) than for contemporary versus historical RPN (six improved categories). However, contemporary RPN outperformed contemporary OPN patients in eight in-hospital outcome categories.</p>

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Comparison of In-Hospital Outcomes at Robot-Assisted Versus Open Partial Nephrectomy

  • 期刊论文

  • 发表日期：

    2025年5月2日

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  • Francesco Di Bello,
  • Natali Rodriguez Penaranda,
  • Andrea Marmiroli,
  • Mattia Longoni,
  • Fabian Falkenbach,
  • Quynh Chi Le,
  • Zhe Tian,
  • Jordan A. Goyal,
  • Claudia Collà Ruvolo,
  • Gianluigi Califano,
  • Massimiliano Creta,
  • Fred Saad,
  • Shahrokh F. Shariat,
  • Stefano Puliatti,
  • Ottavio De Cobelli,
  • Alberto Briganti,
  • Markus Graefen,
  • Felix H. K. Chun,
  • Nicola Longo,
  • Pierre I. Karakiewicz

摘要

Objective

The aim of this work is to quantify the magnitude of improvement in in-hospital outcomes between historical and contemporary robot-assisted partial nephrectomy (RPN) versus historical and contemporary open PN (OPN).

Methods

Within the Nationwide Inpatient Sample (2010–2019), we identified patients who underwent RPN and OPN. Multivariable logistic regression models were fit.

Results

Historical (2010–2014) versus contemporary (2015–2019) proportions were 39% (n = 5,897) versus 61% (n = 9168) for RPN and 59% (n = 7289) versus 41% (n = 5,120) for OPN. Relative to historical, contemporary RPN patients exhibited significantly better in-hospital outcomes in 6 of 12 categories that ranged from−76% for intraoperative complications to−24% for length of stay (LOS) ≥ 75th percentile. Relative to historical, contemporary OPN patients also exhibited significantly better in-hospital outcomes in 7 of 12 categories that ranged from−76% for intraoperative complications to−23% for LOS ≥ 75th percentile. When historical RPN was compared with historical OPN, RPN in-hospital outcomes were better in 10 of 12 comparisons that ranged from−75% for LOS ≥ 75th percentile to−28% for perioperative bleeding. Similarly, when contemporary RPN was compared with contemporary OPN, RPN outcomes were better in 8 of 12 comparisons that ranged from−75% for LOS ≥ 75th percentile to−27% for postoperative complications.

Conclusion

The magnitude of improvement in in-hospital outcomes was more pronounced for contemporary versus historical OPN (seven improved categories) than for contemporary versus historical RPN (six improved categories). However, contemporary RPN outperformed contemporary OPN patients in eight in-hospital outcome categories.