title: Utilization and perioperative complications of laparoscopic cryoablation vs. robotic partial nephrectomy for localized renal tumors.
abstract: OBJECTIVE
  To compare the utilization, perioperative complications and predictors of LCA versus RPN in the treatment of localized renal tumors.
  
  
  METHODS
  From the Nationwide Inpatient Sample we identified patients undergoing RPN or LCA for the treatment of localized renal tumors from October 2008 through 2010. Patient and hospital-specific factors which predict postoperative complications and use of LCA were investigated.
  
  
  RESULTS
  14,275 patients with localized renal tumors were identified: 70.3% had RPN and 29.7% had LCA. LCA was more common in older patient and at hospitals without robotic consoles. No difference was identified in perioperative complications (0.2% vs. 0.2%), transfusion (5.1% vs. 6.2%), length of stay (2.9 vs. 3.0 days) or median cost ($41,753 vs. $44,618) between the groups, LCA vs. RPN. On multivariate analysis sicker patients were more likely to have LCA (OR 1.34, p=0.048) and sicker patients had greater postoperative complications (OR 3.30, p<0.001); LCA did not predict more complications (OR 1.63, p=0.138) and LCA was performed at hospitals without RCs (OR 0.02, p<0.001). Limitations include observational study design, inability to assess disease severity, operative time, or body mass index, which may affect patient selection and outcomes.
  
  
  CONCLUSIONS
  More patients had RPN vs. LCA; surgical technique was not predictive of postoperative complications. As technology develops to treat localized renal tumors, it will be important to continue to track outcomes and costs for procedures including RPN and LCA.
authors.affiliation: Department of Urology, Columbia University College of Physicians and Surgeons, New York NY, USA.
authors.forename: Aaron C
authors.initials: AC
authors.lastname: Weinberg
authors.affiliation: Department of Urology, Columbia University College of Physicians and Surgeons, New York NY, USA.
authors.forename: Solomon L
authors.initials: SL
authors.lastname: Woldu
authors.affiliation: Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Wen
authors.affiliation: Department of Urology, Columbia University College of Physicians and Surgeons, New York NY, USA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Deibert
authors.affiliation: Department of Urology, Columbia University College of Physicians and Surgeons, New York NY, USA.
authors.forename: Ruslan
authors.initials: R
authors.lastname: Korets
authors.affiliation: Department of Urology, Mount Saini Medical Center, New York, NY, USA.
authors.forename: Ketan K
authors.initials: KK
authors.lastname: Badani
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007431:Intraoperative Complications; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D061646:Operative Time; D012016:Reference Values; D015203:Reproducibility of Results; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D012737:Sex Factors; D016896:Treatment Outcome