title: [Practice uptake in France before and after the 2010 French guidelines on kidney cancer].
abstract: OBJECTIVE
  Compared to the 2007 edition, the 2010 French urological association onco-urology guidelines boarded the indications of partial nephrectomy (PN) as long as the procedure is technically feasible. The aim of this study was to assess national practice with respect to kidney surgery in the 2 years before and after current guidelines.
  
  
  METHODS
  The national database of the Agence Technique de l'Information sur l'Hospitalisation (ATIH) was queried for procedures performed between 2009 and 2010 (era 1) and between 2011 and 2012 (era 2). The coding system of the Classification Commune des Actes Médicaux (CCAM) was used to extract kidney related procedures. For each era, procedures were sorted into partial versus radical nephrectomy (RN), laparoscopic/robotic versus open approach, and private versus public hospital. The two eras were then compared.
  
  
  RESULTS
  Overall, 28,000 and 28,907 procedures were reported in era 1 and 2 with mean 14,000 and 14,450 procedures per year respectively. PN increased from 30% to 35% (P<0.0001) between the two eras. This uptake was similar in public and private hospitals. Accordingly, laparoscopic/robotic approach has significantly increased between the two eras (35% versus 39%, P<0.0001) and even more importantly in public hospitals (P=0.0017). There was a significant increase in laparoscopic/robotic PN as well as a decrease in open RN over the years of the study period.
  
  
  CONCLUSIONS
  This study showed the development of PN and the minimally invasive approach. Over the study period, minimally invasive procedure uptake was higher in public hospitals.
authors.affiliation: Service d'urologie, hôpital Bichat-Claude-Bernard, université Paris-Diderot, Assistance publique des Hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France. Electronic address: idir.ouzaid@free.fr.
authors.forename: I
authors.initials: I
authors.lastname: Ouzaid
authors.affiliation: Service d'urologie, hôpital Bichat-Claude-Bernard, université Paris-Diderot, Assistance publique des Hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France.
authors.forename: J-F
authors.initials: JF
authors.lastname: Hermieu
authors.affiliation: Service d'urologie, hôpital Bichat-Claude-Bernard, université Paris-Diderot, Assistance publique des Hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Hupertan
authors.affiliation: Service d'urologie, hôpital Bichat-Claude-Bernard, université Paris-Diderot, Assistance publique des Hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Dominique
authors.affiliation: Service d'urologie, hôpital Bichat-Claude-Bernard, université Paris-Diderot, Assistance publique des Hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Delmas
authors.affiliation: Service d'urologie, hôpital Bichat-Claude-Bernard, université Paris-Diderot, Assistance publique des Hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Ravery
mesh_terms: D005602:France; D019983:Guideline Adherence; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000706:statistics & numerical data; D009392:Nephrectomy / Q000379:methods* / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D065287:Robotic Surgical Procedures / Q000706:statistics & numerical data
keywords: Cancer du rein; Epidemiology; Guidelines; Recommandations; Renal cell carcinoma; Traitement; Treatment; Épidémiologie