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    
Abstract/OtherAbstract:
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.
Authors:
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.
Affiliation:
Department of Urology, Shintoshi Hospital, Iwata; Department of Urology, The University of Tokyo, Tokyo, Japan.
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