National trends and disparities of minimally invasive surgery for localized renal cancer, 2010 to 2015

Xia, Leilei; Talwar, Ruchika; Taylor, Benjamin; Shin, Michael; Berger, Ian; Sperling, Colin; Chelluri, Raju; Zambrano, Ibardo; Raman, Jay D.; Guzzo, Thomas J.

doi:10.1016/j.urolonc.2018.10.028

Cited by 45 publications

(27 citation statements)

References 49 publications

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“…In the United States (U.S.), blood transfusion rates have steadily declined over 30% in the past decade . Several factors have contributed to this decline, including the availability of revised clinical guidelines, implementation of patient blood management programs, an expanded repertoire of marrow‐sparing and hemostatic agents, and an increase in the practice of minimally invasive surgeries . Despite these advancements, blood transfusion remains common in U.S. hospitals …”

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confidence: 99%

Sociodemographic and behavioral characteristics associated with blood donation in the United States: a population‐based study

et al. 2019

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BACKGROUND Contemporary population‐based data on characteristics associated with blood donation in the United States (U.S.) are limited. STUDY DESIGN AND METHODS A cross‐sectional analysis was performed among 28,739 persons aged 18 years and older who participated in the 2016 National Health Interview Survey, a household survey of the noninstitutionalized U.S. civilian population. Analyses were weighted and accounted for the complex survey design. Adjusted prevalence ratios (aPR) were estimated by multivariable log‐binomial regression. RESULTS The percentage of individuals reporting a past‐year history of blood donation was 5.7% (95% confidence interval [CI], 5.3%‐6.1%) and was highest in the youngest age group (18‐24 years, 8.4%). A past‐year history of blood donation was more common in males compared to females (6.3% vs. 5.1%; aPR, 1.12 [95% CI, 0.99‐1.27]) and those born in the U.S. compared to individuals born outside the U.S. (6.4% vs. 2.4%; aPR, 1.92 [95% CI, 1.49‐2.47]). The percentage of individuals with a past‐year history of blood donation was significantly lower in blacks (3.9%; aPR, 0.60 [95% CI, 0.47‐0.75]) and Hispanics (3.0%; aPR, 0.63 [95% CI, 0.48‐0.83]) in comparison to whites (6.9%). Being a college graduate, being employed, being physically active, and never being a cigarette smoker were factors positively associated with blood donation. The percentage of individuals with a past‐year history of blood donation varied by geographic census region, with prevalence being higher in the Midwest (7.3%) and South (6.0%) compared to the Northeast (4.7%) and West (4.4%). CONCLUSION Continued differences in the blood donor population with reference to the U.S. population underscore the need to understand barriers or deterrents to blood donation. Evidence‐based donor recruitment and related policies remain imperative to ensure that there is a sustainable blood supply.

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confidence: 99%

Sociodemographic and behavioral characteristics associated with blood donation in the United States: a population‐based study

et al. 2019

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“…[ 8 ] With the spread of robotic systems, the rate of RPN increased significantly. [ 22 ] Consistently, the rate of minimally invasive PN has increased over the years. [ 6 ] In this study, we aimed to evaluate our minimally invasive PN experience since introduction of robotic surgery system in our institution.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive partial nephrectomy in the era of robotic surgery

et al. 2020

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Objectives: The objectives of the study were to compare the operative features, complication rates, functional, and pathological outcomes of laparoscopic partial nephrectomy (LPN) and robotic-assisted partial nephrectomy (RPN). Methods: The demographics, perioperative, and follow-up data of patients who underwent partial nephrectomy between January 2007 and April 2020 with minimally invasive methods were retrospectively analyzed. Patients with minimum 3 months follow-up were enrolled in the present study. Perioperative and pathological outcomes were compared between the patients underwent LPN and RPN. Results: A total of 85 patients (65 LPN and 20 RPN) were included in the present study. The mean patient age at the time of surgery was 56.31±10.48 years. Female-to-male ratio was 30/55. Patients in the RPN group had higher R.E.N.A.L. and PADUA scores (p=0.039 and p=0.030, respectively). Median warm ischemia time, median operation time, median intraoperative estimated blood loss, mean post-operative hemoglobin change, and median hospitalization time were similar between groups (p=0.133, p=0.753, p=0.079, p=0.882, and p=0.473, respectively). Artery-only clamping rate was significantly higher in RPN group (p=0.033). The cost of RPN was significantly greater than LPN (p<0.001). Transfusion rates, post-operative complication rates, percent of estimated glomerular filtration rate change at the last follow-up, and trifecta achievement were similar between the groups (p=0.622, p=0.238, p=0.428, and p=0.349, respectively). Conclusion: In this series, similar perioperative and functional outcomes were achieved by RPN compared to LPN in more complex renal masses.

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“…Partial nephrectomy has largely become the standard of surgical care for the treatment of small renal masses. Minimally invasive PN options, including straight laparoscopy (SL), hand-assisted laparoscopy (HAL), and robot-assisted laparoscopy (RAL), have increasingly become utilized in different institutional settings [5,6]. Laparoscopicbased techniques have gradually overshadowed the open approach, as they offer much of the same operational benefits with a noticeable decrease in morbidity.…”

Section: Introductionmentioning

confidence: 99%

“…There are racial/ethnic and socioeconomic-related disparities in a patient's ability to access to these minimally invasive techniques for the management of small renal masses [6]. To our knowledge, there are no studies evaluating the trends of minimally invasive techniques for the management of small renal masses at a large safety net hospital.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Minimally Invasive Surgical Approaches in the Management of Small Renal Masses at a Safety Net Hospital

Wang¹,

Apoj²,

Lim³

et al. 2021

IJCU

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Partial nephrectomy can be performed with traditional straight laparoscopy (SL), hand-assisted laparoscopic (HAL) and robotic-assisted laparoscopic (RAL) techniques. The purpose of this study is to analyze trends in surgical technique and compare the intra-and post-operative outcomes at a safety net hospital. We performed a single-institution retrospective review of intra-and post-operative outcomes in partial nephrectomy cases between 2012 and 2018. We analyzed the impact of patient demographics, tumor characteristics, and RENAL nephrometry score on surgical outcomes and post-operative complications among the three surgical approaches to partial nephrectomy. Of the 164 partial nephrectomies, 36 were SL, 65 HAL, and 63 RAL. Most SL was performed in the early years, whereas most RAL was performed in the later years, and HA was evenly distributed throughout the years. There was no difference in demographics, intra-operative complications, estimated blood loss, or positive margin rates between SL, HAL, and RAL. HAL partial nephrectomies had a higher RENAL nephrometry score and had statistically significant less warm ischemia and operative times when compared to RAL. HAL is a worthwhile technique in larger and more complex masses and especially in settings where robotic surgery is unable to be performed.

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National trends and disparities of minimally invasive surgery for localized renal cancer, 2010 to 2015

Cited by 45 publications

References 49 publications

Sociodemographic and behavioral characteristics associated with blood donation in the United States: a population‐based study

Sociodemographic and behavioral characteristics associated with blood donation in the United States: a population‐based study

Minimally invasive partial nephrectomy in the era of robotic surgery

Comparison of Minimally Invasive Surgical Approaches in the Management of Small Renal Masses at a Safety Net Hospital

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