PD01-03 OUTCOMES AND FINANCIAL IMPACTS OF MINI PCNL IN STONES LARGER THAN 1.5 CENTIMETERS VERSUS PCNL

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy I (PD01)1 Apr 2020PD01-03 OUTCOMES AND FINANCIAL IMPACTS OF MINI PCNL IN STONES LARGER THAN 1.5 CENTIMETERS VERSUS PCNL John Fisher*, Winston Crute, Joshua Earl, Kevin Reed, John Lacy, Wesley White, and Ryan Pickens John Fisher*John Fisher* More articles by this author , Winston CruteWinston Crute More articles by this author , Joshua EarlJoshua Earl More articles by this author , Kevin ReedKevin Reed More articles by this author , John LacyJohn Lacy More articles by this author , Wesley WhiteWesley White More articles by this author , and Ryan PickensRyan Pickens More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000821.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Minimally invasive, outpatient procedures remain in vogue in the field of urology for both cost savings and patient satisfaction. The adoption of mini percutaneous nephrolithotomy (PCNL) from pediatric cases in the adult population allows the patient to undergo lithotripsy of larger stone burden with a smaller caliber sheath. Reduced bleeding, improved visibility, and shortened hospital stay are a few suggested benefits of this approach. In this study, we have attempted to quantify the potential cost savings in our experience utilizing mini PCNL in patients with stones >1.5 compared to traditional PCNL. METHODS: A retrospective review was performed over the period June 2016 to August 2019 to collect all patient records who underwent mini PCNL. Patients were excluded if less than 1.5 cm of stone was treated. The costs assessed were based on a single institutions charges for hospitalization, surgical fees and instruments used during the procedures. RESULTS: In this study, greater than 1.5 cm of stone was treated in 173 of the 189 mini PCNLs. The average age was 53.8, BMI was 32.1, and the population was 54% female. In 53% of cases, multiple stones were present and average stone burden was 2.5 cm (1.5-6.6 cm). Average surgical time was 74 minutes with 28 cc of blood loss. Stents were left in 45% (78/173) of patients and nephrostomy tubes in 24% (42/173). Average date of discharge was postoperative day 0.6 with 63.5% of patients discharged on the day of surgery compared to 2.3 days for PCNL over the same period. Typical cost of mini PCNL was $777(USD) versus $1659 for PCNL and cost for nephrostomy tubes and stents were $70 and $50 respectively. CONCLUSIONS: Practitioners may offer mini PCNL as a primary therapy for stones >1.5 cm for expeditious, minimally invasive stone clearance. The potential cost savings for stones treatment in this population is reflected in both instrument costs as well as the hospital cost associated with additional days of inpatient care. Source of Funding: No source of funding © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e61-e61 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Fisher* More articles by this author Winston Crute More articles by this author Joshua Earl More articles by this author Kevin Reed More articles by this author John Lacy More articles by this author Wesley White More articles by this author Ryan Pickens More articles by this author Expand All Advertisement PDF downloadLoading ...