MP44-14 DIFFERENCES IN SURGICAL APPROACH TO NEPHRECTOMY BASED ON FELLOWSHIP-TRAINING STATUS: A STUDY OF THE AMERICAN BOARD OF UROLOGY CASE LOGS

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy III (MP44)1 May 2024MP44-14 DIFFERENCES IN SURGICAL APPROACH TO NEPHRECTOMY BASED ON FELLOWSHIP-TRAINING STATUS: A STUDY OF THE AMERICAN BOARD OF UROLOGY CASE LOGS Natalie Passarelli, Alexa Steckler, Borivoj Golijanin, Rongqi Zhang, and Elias Hyams Natalie PassarelliNatalie Passarelli , Alexa StecklerAlexa Steckler , Borivoj GolijaninBorivoj Golijanin , Rongqi ZhangRongqi Zhang , and Elias HyamsElias Hyams View All Author Informationhttps://doi.org/10.1097/01.JU.0001009508.69111.d0.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While fellowship training can augment skills in robotic-assisted laparoscopic (RAL) surgery, more urologists are acquiring RAL skills within residency as these procedures become more common. Nephrectomy can be performed via open, laparoscopic, or RAL approaches; thus, this procedure can be used to assess whether fellowship training may or may not be associated with surgical approach. This study evaluates the relationship between fellowship training status and chosen approach for nephrectomy to determine how practice patterns vary based on training background. METHODS: CPT codes for extirpative renal surgery were selected from the American Board of Urology case logs (2012-2022) including 50220, 50543, 50545, and the robot specific S2900. Nephrectomies done by each approach were recorded, stratified by physician fellowship status, and compared using a Chi-squared test of independence. RESULTS: A total of 26,261 nephrectomies were performed. 7,788 (29.7%) were performed by fellowship trained urologist versus 18,473 (70.3%) by non-fellowship trained urologists. Those with fellowship training performed 1,201 (15.4%) open , 5,470 (70.2%) laparoscopic, and 1,117 (14.3%) robotic nephrectomies. Non-fellowship trained physicians performed 3,636 (13.8%) open, 14,265 (77.2%) laparoscopic, and 1,773 (9.6%) robotic nephrectomies. Those with fellowship training performed significantly higher rates of RAL nephrectomy (RALN) versus those without fellowship training (p<0.0001). CONCLUSIONS: Most nephrectomies were performed laparoscopically during the study period, however urologists with fellowship training performed RALN at a higher proportion. This may reflect augmented skill sets and comfort with RAL surgery. As robotic surgery is taught more frequently in residency, favored approaches may change with time. Clinical and cost implications of these practice patterns based on training background warrant further evaluation. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e736 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Natalie Passarelli More articles by this author Alexa Steckler More articles by this author Borivoj Golijanin More articles by this author Rongqi Zhang More articles by this author Elias Hyams More articles by this author Expand All Advertisement PDF downloadLoading ...