National Trends of Perioperative Outcomes and Costs for Open, Laparoscopic and Robotic Pediatric Pyeloplasty Briony K. Varda,* Emilie K. Johnson, Curtis Clark, Benjamin I. Chung, Caleb P. Nelson and Steven L. Chang From the Division of Urologic Surgery, and Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School (BKV, SLC) and Department of Urology, Boston Children’s Hospital (BKV, EKJ, CPN), Boston, Massachusetts, Pediatric and Adolescent Urology, Inc., Akron, Ohio (CC), and Department of Urology, School of Medicine, Stanford University, Stanford, California (BIC)
Abbreviations and Acronyms LOS ¼ length of stay LP ¼ laparoscopic pyeloplasty MIP ¼ minimally invasive pyeloplasty OP ¼ open pyeloplasty OT ¼ operative time RP ¼ robotic pyeloplasty Accepted for publication October 10, 2013. * Correspondence: Division of Urology, Brigham and Women’s Hospital, 75 Francis St., Boston, Massachusetts 02115 (e-mail: bvarda@ partners.org).
Purpose: We performed a population based study comparing trends in perioperative outcomes and costs for open, laparoscopic and robotic pediatric pyeloplasty. Specific billing items contributing to cost were also investigated. Materials and Methods: Using the Perspective database (Premier, Inc., Charlotte, North Carolina), we identified 12,662 pediatric patients who underwent open, laparoscopic and robotic pyeloplasty (ICD-9 55.87) in the United States from 2003 to 2010. Univariate and multivariate statistics were used to evaluate perioperative outcomes, complications and costs for the competing surgical approaches. Propensity weighting was used to minimize selection bias. Sampling weights were used to yield a nationally representative sample. Results: A decrease in open pyeloplasty and an increase in minimally invasive pyeloplasty were observed. All procedures had low complication rates. Compared to open pyeloplasty, laparoscopic and robotic pyeloplasty had longer median operative times (240 minutes, p
Abbreviations and Acronyms LOS ¼ length of stay LP ¼ laparoscopic pyeloplasty MIP ¼ minimally invasive pyeloplasty OP ¼ open pyeloplasty OT ¼ operative time RP ¼ robotic pyeloplasty Accepted for publication October 10, 2013. * Correspondence: Division of Urology, Brigham and Women’s Hospital, 75 Francis St., Boston, Massachusetts 02115 (e-mail: bvarda@ partners.org).
Purpose: We performed a population based study comparing trends in perioperative outcomes and costs for open, laparoscopic and robotic pediatric pyeloplasty. Specific billing items contributing to cost were also investigated. Materials and Methods: Using the Perspective database (Premier, Inc., Charlotte, North Carolina), we identified 12,662 pediatric patients who underwent open, laparoscopic and robotic pyeloplasty (ICD-9 55.87) in the United States from 2003 to 2010. Univariate and multivariate statistics were used to evaluate perioperative outcomes, complications and costs for the competing surgical approaches. Propensity weighting was used to minimize selection bias. Sampling weights were used to yield a nationally representative sample. Results: A decrease in open pyeloplasty and an increase in minimally invasive pyeloplasty were observed. All procedures had low complication rates. Compared to open pyeloplasty, laparoscopic and robotic pyeloplasty had longer median operative times (240 minutes, p
