Document Detail

Comparisons of perioperative outcomes and costs between open and laparoscopic radical prostatectomy: A propensity-score matching analysis based on the Japanese Diagnosis Procedure Combination database.
MedLine Citation:
PMID:  23320826     Owner:  NLM     Status:  Publisher    
We compared perioperative outcomes and costs between open and laparoscopic radical prostatectomy for prostate cancer. The Japanese Diagnosis Procedure Combination database, including cases from 2007 to 2010, was used by one-to-one propensity-score matching. The following items were compared: complication rate; homologous and autologous transfusion rate; first cystography day and cystography repeat rate; anesthesia time; postoperative length of stay; and costs. Multivariate analyses were carried out by including age, Charlson Comorbidity Index, T stage, hospital volume and hospital academic status as variables. As a result, among 15 616 open and 1997 laparoscopic radical prostatectomies, 1627 propensity-score matched pairs were generated. The laparoscopic approach showed a better overall complication rate (3.4% vs 5.0%), homologous transfusion rate (3.3% vs 9.2%), autologous transfusion rate (44.9% vs 79.3%), first cystography day (mean 6th vs 7th day), mean postoperative length of stay (mean 11 vs 13 days), and cost without surgery and anesthesia (mean $7965 vs $9235; all P < 0.001). Anesthesia time was longer (mean 345 vs 285 min) and total cost was higher (mean $14 980 vs $12 356) for the laparoscopic approach (both P < 0.001). The secondary cystography rates were comparable between the groups (18.3% vs 15.7%, P = 0.144). The multivariate analyses showed similar trends. In conclusion, these findings confirm several benefits of laparoscopy over open approach for radical prostatectomy.
Toru Sugihara; Hideo Yasunaga; Hiromasa Horiguchi; Nobuo Tsuru; Hiroyuki Ihara; Tetsuya Fujimura; Hiroaki Nishimatsu; Kazuhiko Ohe; Kiyohide Fushimi; Yukio Homma
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-16
Journal Detail:
Title:  International journal of urology : official journal of the Japanese Urological Association     Volume:  -     ISSN:  1442-2042     ISO Abbreviation:  Int. J. Urol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440237     Medline TA:  Int J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 The Japanese Urological Association.
Department of Urology, Shintoshi Hospital, Iwata; Department of Urology, The University of Tokyo, Tokyo, Japan.
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