Partial and radical nephrectomy in children, adolescents, and young adults: Equivalent readmissions and postoperative complications.

Published

Journal Article

OBJECTIVES: To compare and contrast the use of partial nephrectomy (PN) and radical nephrectomy (RN) in pediatric malignant renal tumors using a nationally representative database. METHODS: The 2010-2014 Nationwide Readmissions Database (NRD) was used to obtain PN and RN select postoperative data. ICD-9-CM codes were used to identify children (<10 years), adolescents (10-19 years) and young adults (20-30 years) diagnosed with malignant renal tumors who were treated with a PN or RN. The presence of a 30-day readmission, occurrence of postoperative complications, cost, and length of stay (LOS) were studied and weighted logistic regression models were fit to test for associations. RESULTS: There were 4330 weighted encounters (1289 PNs, 3041 RNs) that met inclusion criteria: 50.8% were children, 7.2% were adolescents, and 42% were young adults. Young adults had the highest rates of PN, whereas children had the highest rates of RN (p < 0.0001). Overall, no evidence was found to suggest a difference in odds between surgical modality and the presence of a 30-day readmission or postoperative complication. While PN was on average $9000 cheaper compared to RN overall, its cost was similar to that of RN for children. Similarly, PN patients had a shorter overall LOS compared to RN patients, but their LOS was similar to that of children who underwent RN. CONCLUSION: There was no evidence of a difference in odds between RN and PN in terms of postoperative readmissions or in-hospital complication rates. Additionally, we observed descriptive differences in both cost and LOS between the surgical modalities across age groups. TYPE OF STUDY: Retrospective comparative study (administrative database analysis). LEVEL OF EVIDENCE: Level III.

Full Text

Duke Authors

Cited Authors

  • Alkazemi, MH; Dionise, ZR; Jiang, R; Wolf, S; Pomann, G-M; Tracy, ET; Rice, HE; Routh, JC

Published Date

  • November 2019

Published In

Volume / Issue

  • 54 / 11

Start / End Page

  • 2343 - 2347

PubMed ID

  • 31178166

Pubmed Central ID

  • 31178166

Electronic International Standard Serial Number (EISSN)

  • 1531-5037

Digital Object Identifier (DOI)

  • 10.1016/j.jpedsurg.2019.05.018

Language

  • eng

Conference Location

  • United States