Examining the relationship between operative time and hospitalization time in minimally invasive and open urologic procedures.
OBJECTIVE
To explore the relationship between operative time, approach, and length of stay (LOS) in partial nephrectomy (PN), radical prostatectomy (RP), and adrenalectomy (AD).


METHODS
Using the National Surgical Quality Improvement Program database, we identified all PN, RP, and AD from 2010 to 2012. Non-prostate cancer RP were excluded. The primary outcome was LOS. Descriptive comparisons were drawn between open and minimally invasive surgery (MIS) for each surgery. Multiple linear regression assessed the impact of open versus MIS and operative time on LOS when controlling for confounders.


RESULTS
We identified 3760 PN (60% MIS), 12,081 RP (82% MIS), and 1684 AD (76% MIS) cases for inclusion. Differences in operative time were identified. In PN and RP, MIS mean operative time was 10 to 23 minutes longer (p<0.001 each); while for AD, open was 35 minutes longer (p<0.001). Open procedures had consistently longer median LOS (p<0.001 all). Results of the linear regression are given next.


CONCLUSIONS
Operative time and surgical approach are directly associated with LOS, independent of complications and patient comorbidities.
Department of Urology, Indiana University School of Medicine , Indianapolis, Indiana.
M Francesca
MF
Monn
Rajat
R
Jain
Hristos Z
HZ
Kaimakliotis
Chandra K
CK
Flack
Michael O
MO
Koch
Ronald S
RS
Boris
D000315:Adrenalectomy / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods / Q000706:statistics & numerical data*; D061646:Operative Time; D011468:Prostatectomy / Q000379:methods / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D014572:Urology