55 A single–site comparison of laparoscopic versus open radical nephrectomy: Length of postoperative hospital stay

55 A single–site comparison of laparoscopic versus open radical nephrectomy: Length of postoperative hospital stay Jakubovskis M.1, Vaivode I.2, Vitenberga Z.3, Vlažņevs M4, Cauce V.5, Beketovs S.1, Menis A.1, Gordins S.1, Lietuvietis V.1 1 Riga East University Hospital, Dept. of Urology, Riga, Latvia, 2Riga East University Hospital, Dept. of Oncology, Riga, Latvia, 3Riga Stradins University, Dept. of Morphology, Riga, Latvia, 4Riga Stradins University, Faculty of Continuing Education, Riga, Latvia, 5Riga Stradins University, Dept. of Physics, Riga, Latvia INTRODUCTION & OBJECTIVES: According to the data provided by the Centre for Disease Prevention and Control of Latvia during the last decade the same trend is observed in Latvia like elsewhere in Europe increasing incidence and stabilization of mortality rates with renal cancers (per 100 000 incidence in 2003 – 17.0, in 2013 – 22.9, mortality in 2003 – 7.0, in 2013 – 9.7). The only radical treatment of renal cell carcinoma (RCC) is surgical. Laparoscopy has well established advantages over open surgery. Nevertheless Lap surgery is slowly accepted by Latvian urologists due to lack of skills and lengthy learning curve. In 2013 – 2014 totally 433 patients underwent renal surgery at the Urology Clinic of Riga East University Hospital, among them 235 – radical nephrectomies (RN), out of which 39 (16.6%) were laparoscopic. In 2009 – 2010 the number of Lap RN was significantly lower - 24 (10.3%) out of 233. The objective of the study was to access the gain provided by the laparoscopic versus open RN from the perspective of individual subject and whole institution by comparing the length of the postoperative hospital stay. MATERIAL & METHODS: A retrospective analysis was performed in 137 patients who underwent surgery for kidney tumors between 2009 and 2014 at our clinic. Following data was collected from medical records: age, tumor size, and days spent at the hospital after operation. Categorical data among the groups was compared by using the chi square test and continues variables were analyzed with independent sample T test if the data was normally distributed or Mann-Whitney U test in case of abnormal distribution. RESULTS: The number of subjects was 57 in laparoscopic and 80 in open surgery groups. No statistical differences were found in terms of age and sex between both arms, but tumor size and duration of hospitalization differed significantly (p < 0.001). Mean (M) number of days spent at the hospital after open surgery was 7.7 with standard deviation (SD) 2.4 median (Me) 6, mode (Mo) 7, but after laparoscopy the respective figures were: M = 6.0 + 2.3, Me = 4, Mo = 4. Regarding the tumor size in open surgery group: M = 7.1 + 3.5 cm; laparoscopic group: M = 4.5 + 2.1 cm. CONCLUSIONS: Our study results demonstrate that tumor size is one of the factors playing a role in the choice of the method: open versus Lap RN, but it is independent of the patient’s age. The time spent at the hospital after operation is in average 2 days shorter for patients undergoing Lap surgery suggesting possible individual and institutional benefit of this method. Eur Urol Suppl 2015; 14(3): e1151