Journal of endourology
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Journal of endourology · Apr 2014
Multicenter Study Comparative StudyNational multi-institutional comparison of 30-day postoperative complication and readmission rates between open retropubic radical prostatectomy and robot-assisted laparoscopic prostatectomy using NSQIP.
Many American hospitals will soon face readmission penalties deducted from Medicare reimbursements, which will place further scrutiny on techniques that may offer reduced postoperative morbidity. We aimed to perform the first multi-institutional study using the National Surgical Quality Improvement Program (NSQIP) database, to compare predictors of readmission within cohorts of open radical retropubic prostatectomy (RRP) and robot-assisted laparoscopic radical prostatectomy (RALRP) in a contemporary nationwide series of radical prostatectomy. ⋯ This is the first multi-institutional retrospective study that examines readmission rates and procedural intracohort predictors of readmission for RRP in the contemporary United States. We report a significant difference in postoperative complication and readmission rates in RRP compared with RALRP. Further prospective analysis is warranted.
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Journal of endourology · Mar 2014
Multicenter StudyPostoperative complications after percutaneous nephrolithotomy: a contemporary analysis by insurance status in the United States.
No published data to date have assessed the insurance-related disparities among patients undergoing percutaneous nephrolithotomy (PCNL). Our objective was to examine whether being uninsured is associated with more perioperative complications after PCNL in the United States and to determine possible risk factors that influence PCNL outcomes. ⋯ Perioperative morbidity after PCNL varied significantly with insurance status, but this variation was explained mostly by differences in overall health status.
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Journal of endourology · Dec 2013
Multicenter StudyAdmission rates and costs associated with emergency presentation of urolithiasis: analysis of the Nationwide Emergency Department Sample 2006-2009.
We sought to examine a large nationwide (United States) sample of emergency department (ED) visits to determine data related to utilization and costs of care for urolithiasis in this setting. ⋯ Presentation of urolithiasis to the ED is common, and is associated with significant costs to the medical system, which are increasing over time. Costs and rates of admission differ by region, payer type, and hospital type, which may allow us to identify the causes for cost discrepancies and areas to improve efficiency of care delivery.
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Journal of endourology · Oct 2010
Multicenter StudyFlexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm: a multi-institutional experience.
Percutaneous nephrostolithotomy (PCNL) is the current standard of care for management of large renal stones (>2 cm). Recent studies have evaluated flexible ureterorenoscopy (URS)/holmium laser lithotripsy as an alternative treatment for patients with contraindications to or preference against PCNL. Stones in an intermediate size range (2-3 cm) may be most amenable to URS/laser lithotripsy as definitive treatment in a single stage. We report a multi-institutional series of URS/laser lithotripsy for renal stone burdens that measure 2 to 3 cm. ⋯ We demonstrate that single-stage URS/holmium laser lithotripsy is effective for management of renal stones that measure 2 to 3 cm through intermediate follow-up. Staged procedures can be used selectively for technical reasons or disease factors. Although PCNL achieves superior stone clearance overall, URS/laser lithotripsy is a viable treatment option for selected patients.