Introduction:
The implementation of laparoscopic and robotic technology has improved the surgical technique for many abdominal procedures, allowing patients to be treated as an outpatient. The objective of this study is to compare complications and readmission rates of patients undergoing outpatient versus inpatient minimally invasive partial nephrectomy.
Methods:
Using the National Surgical Quality Improvement Program data of the American College of Surgeons (ACS-NSQIP), we identified all patients that underwent a minimally invasive partial nephrectomy (CPT: 50543) between 2010-2020. Subjects were stratified based on outpatient and inpatient status. Baseline characteristics, complications, and 30-day events were compared to determine any significant differences.
Results:
From 2010-2020, a total of 28,227 subjects underwent a minimally invasive partial nephrectomy of which 98.9% were inpatient and 1.1% were outpatient. Operative time was longer for inpatient subjects versus outpatient subjects (165.1 mins vs. 184.3 mins, p<0.0001). No significant differences in comorbidities were seen between the two groups. Outpatient subjects had a higher rate of cardiac arrest when compared to the inpatient group (1.3% vs. 0.2%, p=0.004); however, there was no significant difference for any other complication. Thirty-day mortality appears worse in the outpatient group (1.3% vs 0.2%, p=0.004), but showed similar return to OR (0.7% vs 1.7%, p=0.171) and readmission rates (3.4% vs 4.8%, p=0.350). There is an upward trend in outpatient partial nephrectomies since 2010.
Conclusion:
Findings of this study noted an increased risk of cardiac arrest and 30-day mortality following outpatient partial nephrectomy when compared to inpatient procedures. As such, further investigation is required to evaluate the safety and feasibility of outpatient partial nephrectomy.
Funding: N/A
Image(s) (click to enlarge):
SAFETY AND FEASIBILITY OF OUTPATIENT PARTIAL NEPHRECTOMY IN A NATIONAL COHORT
Category
Kidney Cancer > Localized
Description
Poster #19
Wednesday, November 30
2:00 p.m. - 3:00 p.m.
Presented By: Spencer S. Liem
Authors:
Dhaval Jivanji
Timothy Demus
Shuwei Peter Chang
Shimron Brown
Akshay Bhandari
Jorge F. Pereira