| アブストラクト | OBJECTIVES: To elucidate the differences in clinical practice between the USA and Japan in major types of uro-oncological surgery by a head-to-head comparison of national databases in the two countries. METHODS: We compared variations in surgical modality, length of stay, total charges, caseload centralization, transfusion incidence, and in-hospital mortality between the two countries for four major types of uro-oncological surgery (radical prostatectomy, radical cystectomy, nephrectomy and nephroureterectomy) in 2011. Additionally, the chronological changes in surgical modalities were investigated for 2009-11. The national estimates were based on data from the Japanese Diagnosis Procedure Combination database and the US National Inpatient Sample. RESULTS: For radical prostatectomy, radical cystectomy, nephrectomy and nephroureterectomy, minimally-invasive surgery accounted for 24.2% versus 70.2%, 0% versus 14.0%, 50.7% versus 30.7% and 50.2% versus 30.5%, respectively, in Japan versus the USA in 2011. Although minimally-invasive surgery has become increasingly frequent in both countries, the major procedures were robot-assisted surgery in the USA and laparoscopic surgery in Japan. The USA was generally characterized by a slightly younger age at operation, far higher hospital volume, a shorter length of stay, higher charges and less use of transfusion than Japan. CONCLUSIONS: The findings suggest substantial differences between the USA and Japan regarding clinical practices in uro-oncological surgery. Standing at the beginning of robotic surgery era in Japan, the precise recognition of these differences will aid a proper understanding of clinical practices. |
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| ジャーナル名 | International journal of urology : official journal of the Japanese Urological Association |
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| 投稿日 | 2014/07/22 |
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| 投稿者 | Sugihara, Toru; Yasunaga, Hideo; Horiguchi, Hiromasa; Fushimi, Kiyohide; Dalton, Jarrod E; Schold, Jesse; Kattan, Michael W; Homma, Yukio |
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| 組織名 | Department of Quantitative Health Sciences, Cleveland Clinic Foundation,;Cleveland, Ohio, USA; Department of Urology, The University of Tokyo, Tokyo,;Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/25040427/ |
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