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• W1985133722 abstract "No AccessJournal of UrologyAdult Urology1 Mar 2015Population Based Analysis of Incidence and Predictors of Open Conversion during Minimally Invasive Radical Prostatectomy Adam B. Weiner, Prithvi Murthy, Kyle A. Richards, Sanjay G. Patel, and Scott E. Eggener Adam B. WeinerAdam B. Weiner Section of Urology, University of Chicago Medical Center, Chicago, Illinois More articles by this author , Prithvi MurthyPrithvi Murthy Section of Urology, University of Chicago Medical Center, Chicago, Illinois More articles by this author , Kyle A. RichardsKyle A. Richards Section of Urology, University of Chicago Medical Center, Chicago, Illinois Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author , Sanjay G. PatelSanjay G. Patel Section of Urology, University of Chicago Medical Center, Chicago, Illinois More articles by this author , and Scott E. EggenerScott E. Eggener Section of Urology, University of Chicago Medical Center, Chicago, Illinois More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.09.113AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We used population based data to measure the rates and risk factors of open conversion during minimally invasive radical prostatectomy in the United States. Materials and Methods: We retrospectively analyzed the records of 87,415 patients in the NCDB who underwent minimally invasive radical prostatectomy between 2010 and 2011. We compared surgical outcomes and treatment facility characteristics between converted and nonconverted cases. Multivariable analysis was done to evaluate conversion risk factors. Results: There were 82,338 robot-assisted (94%) and 5,077 laparoscopic (6%) radical prostatectomies, and 1,080 conversions (1.2%). Fewer robot-assisted cases were converted than laparoscopic cases (0.9% vs 6.5%, p <0.001). The median yearly treatment facility volume of minimally invasive radical prostatectomy was 32 (IQR 10–72). Patients who underwent conversion were more likely to be rehospitalized within 30 days (4.4% vs 2.7%, p = 0.002) and have a postoperative hospital stay of greater than 2 days (40.4% vs 15.1%, p <0.001) than those without conversion. Facilities in the lowest quartile of the yearly volume of the minimally invasive procedure represented 3.8% of minimally invasive radical prostatectomies but accounted for 22.9% of conversions. The second, third and fourth quartiles of yearly treatment facility minimally invasive volume predicted a lower likelihood of conversion compared to the first quartile (each p <0.001). Facility type (eg academic or community) did not predict conversion. Black race (vs white OR 1.52, 95% CI 1.24–1.86, p <0.001) and laparoscopic radical prostatectomy (OR 4.68, 95% CI 3.79–5.78, p <0.001) predicted higher odds of conversion. Conclusions: Open conversion during minimally invasive radical prostatectomy is a rare event. However, it is significantly more likely for pure laparoscopic surgery, in black men and at low volume facilities. Facility type did not affect conversion rates. References 1 : Comparative effectiveness of robot-assisted versus open radical prostatectomy cancer control. Eur Urol2014; 66: 666. Google Scholar 2 : Contemporary open and robotic radical prostatectomy practice patterns among urologists in the United States. J Urol2012; 187: 2087. Link, Google Scholar 3 : Perioperative outcomes of robot-assisted radical prostatectomy compared with open radical prostatectomy: results from the nationwide inpatient sample. Eur Urol2012; 61: 679. Google Scholar 4 : Learning curves for urological procedures: a systematic review. 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Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 3March 2015Page: 826-831Supplementary Materials Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordssurgical proceduresminimally invasiveprostatectomylaparoscopyintraoperative complicationsprostatic neoplasmsAcknowledgmentsSandra Ham assisted with statistical analysis.MetricsAuthor Information Adam B. Weiner Section of Urology, University of Chicago Medical Center, Chicago, Illinois More articles by this author Prithvi Murthy Section of Urology, University of Chicago Medical Center, Chicago, Illinois More articles by this author Kyle A. Richards Section of Urology, University of Chicago Medical Center, Chicago, Illinois Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author Sanjay G. Patel Section of Urology, University of Chicago Medical Center, Chicago, Illinois More articles by this author Scott E. Eggener Section of Urology, University of Chicago Medical Center, Chicago, Illinois More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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