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Hospital-Based Analysis of Trends and Outcomes for Patients Undergoing Pyelolithotomy
Charles U Nottingham1, Andrew J Cohen1, Vignesh T Packiam1
1Department of Surgery, Section of Urology, University of Chicago Medicine , Chicago, Illinois.
Journal of Endourology
|October 28, 2016
Summary
Minimally invasive pyelolithotomy (MI) is increasing, though overall cases are stable. Patient and hospital factors significantly influence complication risk, not the surgical approach itself.
Area of Science:
- Urology
- Surgical Techniques
- Health Services Research
Background:
- Pyelolithotomy is a procedure to remove kidney stones from the renal pelvis.
- Trends in surgical approaches and associated outcomes are crucial for patient care and resource allocation.
Purpose of the Study:
- To analyze trends in pyelolithotomy procedures.
- To identify risk factors for complications.
- To compare outcomes and costs between open and minimally invasive (MI) pyelolithotomy.
Main Methods:
- Utilized the Nationwide Inpatient Sample (NIS) database (2008-2012).
- Included patients diagnosed with nephrolithiasis undergoing pyelolithotomy.
- Compared outcomes and inflation-adjusted charges between open and MI groups.
Main Results:
- MI pyelolithotomy proportion increased 2.57% annually; total cases remained stable.
- Open surgery had longer length of stay (3.9 vs 2.7 days), but costs were equivalent.
- Higher comorbidity index and genitourinary anomalies increased complication risk; top quartile hospitals and elective status were protective.
- MI technique and simultaneous ureteropelvic junction repair did not impact complication risk.
Conclusions:
- Despite stable overall pyelolithotomy rates, a clear trend towards MI techniques is evident.
- Patient comorbidities and hospital characteristics significantly impact pyelolithotomy complication risks.
- Surgical approach (open vs. MI) did not independently affect complication rates.
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