Evidence map›Paper›PMID 28852937›Full record

ArticleInternational urology and nephrology2017

Surgeon preference of surgical approach for partial nephrectomy in patients with baseline chronic kidney disease: a nationwide population-based analysis in the USA.

Yash S Khandwala, In Gab Jeong, Deok Hyun Han, Jae Heon Kim, Shufeng Li, Ye Wang, Steven L Chang, Benjamin I Chung

Abstract read
PubMed Publisher
In one paragraph

Article in International urology and nephrology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Yash S KhandwalaDepartment of Urology, Stanford University Medical Center, Stanford, CA, USA.
In Gab JeongDepartment of Urology, Stanford University Medical Center, Stanford, CA, USA. igjeong@amc.seoul.kr.ORCID http://orcid.org/0000-0003-4093-832X
Deok Hyun HanDepartment of Urology, Stanford University Medical Center, Stanford, CA, USA.
Jae Heon KimDepartment of Urology, Stanford University Medical Center, Stanford, CA, USA.
Shufeng LiDepartment of Urology and Dermatology, Stanford University Medical Center, Stanford, CA, USA.
Ye WangCenter for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA.
Steven L ChangDivision of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Benjamin I ChungDepartment of Urology, Stanford University Medical Center, Stanford, CA, USA.
Stanford Medicine · USBrigham and Women's Hospital · USAsan Medical Center · KRUniversity of California San Diego · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo examine trends in utilization of open, laparoscopic and robot-assisted surgical approaches for treatment of patients with chronic kidney disease (CKD) undergoing partial nephrectomy (PN) within the USA.

methodsWe analyzed a weighted sample of 112,117 patients from the Premier administrative dataset who underwent PN for renal mass between 2003 and 2015. Proportions of surgical approach utilization were evaluated by CKD status and further stratified by surgery year and surgeon volume. A multivariate logistic regression model was created to predict receipt of minimally invasive PN.

resultsSeven thousand five hundred and sixty-five (6.7%) patients with CKD were identified. The proportion of CKD patients receiving open PN decreased from 72.4% in 2003-2007 to 36.1% in 2012-2015 (p < 0.001). Although the robot-assisted PN was the dominant surgical approach for both patients with and without CKD in 2012-2015, the proportion receiving open PN was higher in patients with CKD compared to those without CKD (p = 0.018). Multivariate analysis showed that the presence of CKD was independently associated with lower odds of receiving a minimally invasive approach (OR 0.47 for the entire study cohort, OR 0.27 for high volume robot-assisted PN surgeons, and OR 0.51 for recent years, all p < 0.001). These trends remained when CKD stages were evaluated individually.

conclusionPatients with CKD undergoing PN were preferentially treated with open surgery despite an overall increase in robot-assisted PN use over the past 13 years. Further studies evaluating surgical outcomes in this population are warranted for determination of optimal approach and construction of evidence-based guidelines.

Indexed as

Administrative Claims, HealthcareAgedFemaleGlomerular Filtration RateHumansLaparoscopyMaleMiddle AgedNephrectomyPractice Patterns, Physicians'Renal Insufficiency, ChronicRobotic Surgical ProceduresUnited StatesChronicLaparoscopyNephrectomyRenal insufficiencyRobotic surgical procedures

Identifiers

PMID28852937
OpenAlexW2753255159

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.