Examining the relationship between operative time and hospitalization time in minimally invasive and open urologic procedures.

Objective: To explore the relationship between operative time, approach, and length of stay (LOS) in partial nephrectomy (PN), radical prostatectomy (RP), and adrenalectomy (AD).
Materials and Methods: Using the National Surgical Quality Improvement Program database, we identified all PN, RP, and AD from 2010 to 2012. Non-prostate cancer RP were excluded. The primary outcome was LOS. Descriptive comparisons were drawn between open and minimally invasive surgery (MIS) for each surgery. Multiple linear regression assessed the impact of open versus MIS and operative time on LOS when controlling for confounders.
Results: We identified 3760 PN (60% MIS), 12,081 RP (82% MIS), and 1684 AD (76% MIS) cases for inclusion. Differences in operative time were identified. In PN and RP, MIS mean operative time was 10 to 23 minutes longer (p<0.001 each); while for AD, open was 35 minutes longer (p<0.001). Open procedures had consistently longer median LOS (p<0.001 all). Results of the linear regression are given next.
Conclusions: Operative time and surgical approach are directly associated with LOS, independent of complications and patient comorbidities.