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• W2000494605 abstract "You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes I1 Apr 20101 COST ANALYSIS OF NEPHRON-SPARING SURGERY FOR RENAL MASSES Raymond Leveillee, Vincent Bird, Rajan Ramanathan, Mohammed Aziz, John Shields, Caulton Darryl, and Ahmed Eldefawry Raymond LeveilleeRaymond Leveillee More articles by this author , Vincent BirdVincent Bird More articles by this author , Rajan RamanathanRajan Ramanathan More articles by this author , Mohammed AzizMohammed Aziz More articles by this author , John ShieldsJohn Shields More articles by this author , Caulton DarrylCaulton Darryl More articles by this author , and Ahmed EldefawryAhmed Eldefawry More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.044AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Cost of health care is an important factor when discussing optimization of health care delivery without hindering outcome, including oncological outcome, and patient quality of life. Our aim is to compare the in-patient cost of patients undergoing nephron-sparing surgeries for renal masses at our institution. We compared computerized tomography-guided radiofrequency ablation (CT- RFA), laparoscopic-guided radiofrequency ablation (L-RFA), laparoscopic partial nephrectomy (LPN), open partial nephrectomy (OPN), and robotic-assisted laparoscopic partial nephrectomy (RA-LPN) as treatments for a renal mass. METHODS From our prospective database we identified the last ten patients undergoing the included procedures: CT-RFA, L-RFA, LPN, OPN, RA-LPN. All procedures took place over a seven year time frame (2002-2009). Patients were matched for tumor size (T1a). Procedures took place in one institution. Data collected for patient parameters included age, co-morbidities, tumor stage, and pathology, as well as cost of laboratory investigations, imaging studies, room and board, operating rooms, disposable equipment, pharmacy, anesthesia service, post-anesthesia care, and transfusion (in-hospital cost). Professional fees for the urologist, anesthesiologist, radiologist, and pathologist were calculated based on Medicare values for uniformity. Total cost for technical approach (including in-patient cost and professional fees) was calculated. Operative time was recorded from patient entry to patient exit from the operating room. RESULTS Table 1 shows the results comparing all five groups. All patients had pathologically confirmed renal cell carcinoma. The operative costs of the five approaches varied according to the different in-patient, professional, and total costs (Figure 1). RA-LPN proved to be associated with the highest total cost ($15,444), followed by LPN (14,380). OPN was intermediate in cost ($10,000). CT-RFA was the most economic approach ($5,643) followed by LRFA ($8,828). CT-RFA also had the lowest in-patient cost. TABLE 1. COST ANALYSIS FOR DIFFERENT TREATMENT MODALITIES FOR RENAL MASS RA-LPN LPN OPN CT RFA LAP RFA Operating room time (mins) 390 318 335 180 180 LOS (days) 2.75 3 3.5 0.5 1.1 Cost In-Hospital $12,579 $11,685 $7,456 $3,401 $6,910 Urologist fee $1,718 $1,718 $1,518 $1,445 $1,344 Anesthiologist fee $920 $750 $799 $460 $460 Pathologist fee $227 $227 $227 $114 $114 Radiologist fee N/A N/A N/A $223 N/A Total Cost $15,444 $14,380 $10,000 $5,543 $8,828 CONCLUSIONS The total medical cost of managing small renal tumors is variable depending on the method of treatment. CT-RFA proved to be the most economic approach followed by LRFA. These procedures were not only noted not only to be the most economical, but also to have the lowest associated in-patient cost. Miami, FL© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e1 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Raymond Leveillee More articles by this author Vincent Bird More articles by this author Rajan Ramanathan More articles by this author Mohammed Aziz More articles by this author John Shields More articles by this author Caulton Darryl More articles by this author Ahmed Eldefawry More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2000494605 title "1 COST ANALYSIS OF NEPHRON-SPARING SURGERY FOR RENAL MASSES" @default.
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