Trends in radical prostatectomy: centralization, robotics, and access to urologic cancer care
Trends in radical prostatectomy: centralization, robotics, and access to urologic cancer care
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DOI：
10.1002/cncr.26274
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发表时间：
2012-01-01
期刊：
影响因子：
6.2
通讯作者：
Uzzo, Robert G.
中科院分区：
文献类型：
--
作者：
Stitzenberg, Karyn B.;Wong, Yu-Ning;Uzzo, Robert G.
背景：机器人手术已被广泛用于根治性直肠癌切除术。我们假设，这种变化正在迅速将程序从不提供机器人的医院转移出去，从而增加了患者的旅行。方法：使用出院数据，对2000年至2009年在纽约、新泽西和宾夕法尼亚州进行的所有肿瘤切除术进行了一项基于人群的观察性研究。医院手术量被定义为在给定的一年中为癌症进行的肿瘤切除术的数量。计算每例患者到治疗医院的直线旅行距离。医院联系，以确定购买第一个机器人的年份。结果：从2000年到2009年，每年进行的子宫切除术总数大幅增加。增加几乎完全发生在手术量很大的中心（>= 106例切除术/年）。从2000年到2009年，进行乳房切除术的医院数量下降了37%。到2009年，9%（21/ 244）的医院进行了57%的手术量，35%（86/244）的医院进行了85%的手术量。从2000年到2009年，中位旅行距离增加了54%（P= 15英里），从24%增加到40%（P
BACKGROUND: Robotic surgery has been widely adopted for radical prostatectomy. We hypothesized that this change is rapidly shifting procedures away from hospitals that do not offer robotics and consequently increasing patient travel. METHODS: A population-based observational study of all prostatectomies for cancer in New York, New Jersey, and Pennsylvania from 2000 to 2009 was performed using hospital discharge data. Hospital procedure volume was defined as the number of prostatectomies performed for cancer in a given year. Straight-line travel distance to the treating hospital was calculated for each case. Hospitals were contacted to determine the year of acquisition of the first robot. RESULTS: From 2000 to 2009, the total number of prostatectomies performed annually increased substantially. The increase occurred almost entirely at the very high-volume centers (>= 106 prostatectomies/year). The number of hospitals performing prostatectomy fell 37% from 2000 to 2009. By 2009, the 9% (21/ 244) of hospitals that had very high volume performed 57% of all prostatectomies, and the 35% (86/244) of hospitals with a robot performed 85% of all prostatectomies. The median travel distance increased 54% from 2000 to 2009 (P= 15 miles increased from 24% to 40% (P