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    Robotic partial nephrectomy: Benefits outweigh costs


    Researchers said they found no evidence that the availability of robot-assisted surgery increased the likelihood that inappropriate patients received partial nephrectomy. The study did find that use of robotic surgery might increase access to partial nephrectomy, which is associated with improvements in 1-year survival rates after surgery and large reductions in renal failure rates. HRRs most likely to offer partial nephrectomy attained significantly lower rates of renal failure in all three time periods studied.

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    Partial nephrectomy improved 1-year mortality by 5.7 percentage points, the authors reported. In comparison, Tan et al found a 5.6 percentage-point improvement in two year mortality (JAMA 2012; 307:1629–35).

    The study used national cancer registry data linked with Medicare claims for 1995–2010, the period in which robotic surgery was adopted into clinical practice. Patient cost and outcome data were derived from the Surveillance, Epidemiology and End Results (SEER) Program, linked to Medicare claims. The study sample included 26,789 Medicare beneficiaries who were diagnosed with kidney cancer between 1996 and 2010 and had a nephrectomy.

    The study has some limitations, including the fact that it focused on kidney cancer, and the results may not be generalizable to other cancers.

    Precision Health Economics conceptualized, designed, conducted the data analysis, and managed the study. Intuitive Surgical said it funded the study and supported article review but had no direct involvement in study execution or data analysis.

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