MP69-16 INPATIENT OUTCOMES OF RADICAL NEPHROURETERECTOMY FOR UPPER TRACT UROTHELIAL CANCER, WITH TRENDS IN UTILIZATION AND IMPACT OF ROBOTIC SURGERY: A NATIONAL INPATIENT SAMPLE ANALYSIS

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You have accessJournal of UrologyCME1 Apr 2023MP69-16 INPATIENT OUTCOMES OF RADICAL NEPHROURETERECTOMY FOR UPPER TRACT UROTHELIAL CANCER, WITH TRENDS IN UTILIZATION AND IMPACT OF ROBOTIC SURGERY: A NATIONAL INPATIENT SAMPLE ANALYSIS Sohrab Arora, Samantha Wilder, Matthew Davis, Nicholas Corsi, Ivan Rakic, Chase Morrison, Rafe Affas, Akshay Sood, Riccardo Autorino, Craig Rogers, and Firas Abdollah Sohrab AroraSohrab Arora More articles by this author , Samantha WilderSamantha Wilder More articles by this author , Matthew DavisMatthew Davis More articles by this author , Nicholas CorsiNicholas Corsi More articles by this author , Ivan RakicIvan Rakic More articles by this author , Chase MorrisonChase Morrison More articles by this author , Rafe AffasRafe Affas More articles by this author , Akshay SoodAkshay Sood More articles by this author , Riccardo AutorinoRiccardo Autorino More articles by this author , Craig RogersCraig Rogers More articles by this author , and Firas AbdollahFiras Abdollah More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003332.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Our primary aim was to evaluate the inpatient morbidity, mortality, and cost of radical nephroureterectomy (NU) for upper tract urothelial cancer (UTUC). We also aimed to evaluate the trends in utilization of robotic surgery for this procedure, and to assess the difference between robotic NU and open NU in terms of the above outcomes from within the National Inpatient Sample (NIS). METHODS: We focused on 9581 records of adult patients with nonmetastatic UTUC undergoing radical NU from 2003-14, representing an estimated 47204 NUs performed in the US during this period. Data after 2014 was excluded due to International Classification of Diseases (ICD) coding change in 2015. ICD-9 code for robotics was introduced in 2008, so data before 2008 was not used when comparing surgical approaches. ICD-9 codes were used to define complications. Complex-survey procedures were used to study descriptive characteristics, and outcomes of patients undergoing NU. Cost of admission was inflation-adjusted to 2014 US dollars. Table: Descriptive statistics and outcomes of radical NU for upper tract urothelial carcinoma in 47204 records from the NIS from 2008-2014, stratified by surgical approach. RESULTS: Overall, the median age of the patients was 72 (IQR 63-79) years. 22974 (49%) patients had a Charlson comorbidity index of 3 or more. 33693 (71%) patients had Medicare/Medicaid insurance. 14692 (31%) patients had complications, with 6814 (14%) having major complications. Significant trend towards use of robotic approach was seen during the study period. Overall, 4635 NUs were performed robotically: accounting for 33% of NUs in 2014. Table 1 shows the outcomes after stratification by approach. Robotic surgery was associated with significantly lower rate of any complications 962 (21%) vs 7675 (33%) for open; p<0.001. This was also true for in hospital mortality (0.3% vs 1.2%; p 0.02), and major complications (10% vs 19%; p<0.001). CONCLUSIONS: Nephroureterectomy is associated with a high inpatient morbidity and mortality. There is increasing utilization of robotic approach in the US. Robotic surgery is associated with lower morbidity and in hospital mortality in these patients. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e970 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sohrab Arora More articles by this author Samantha Wilder More articles by this author Matthew Davis More articles by this author Nicholas Corsi More articles by this author Ivan Rakic More articles by this author Chase Morrison More articles by this author Rafe Affas More articles by this author Akshay Sood More articles by this author Riccardo Autorino More articles by this author Craig Rogers More articles by this author Firas Abdollah More articles by this author Expand All Advertisement PDF downloadLoading ...