Open Access

ARTICLE

Impact of COVID-19 pandemic on ambulatory urologic oncology surgeries

Zhiyu Qian^1,2, Jamie Ye², David F. Friedlander³, Mara Koelker^1,2, Muhieddine Labban^1,2, Bjoern Langbein^1,2, Cheryl Chang-Rong Chen^1,2, Mark A. Preston^1,2, Timothy Clinton¹, Matthew Mossanen^1,2, Firas Abdullah^4,5, Stuart R. Lipsitz², Adam S. Kibel^1,2, Quoc-Dien Trinh^1,2, Alexander P. Cole^1,2

1 Department of Urology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
2 Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
3 Department of Urology, University of North Carolina Medical Center, Chapel Hill, North Carolina, USA
4 VCORE - Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation, Henry Ford Hospital, Detroit, Michigan, USA
5 Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USA
Address correspondence to Dr. Alexander P. Cole, Division of Urological Surgery, Brigham and Women’s Hospital, 45 Francis St, ASB II-3; Boston, MA 02115 USA

Canadian Journal of Urology 2023, 30(6), 11714-11723.

Abstract

Introduction: Robot-assisted laparoscopic prostatectomy (RALP) and transurethral resection of bladder tumor (TURBT) are two common surgeries for prostate and bladder cancer. We aim to assess the trends in the site of care for RALP and TURBT before and after the COVID outbreak.
Materials and methods: We identified adults who underwent RALP and TURBT within the California Healthcare Cost and Utilization Project State Inpatient Database and the State Ambulatory Surgery Database between 2018 and 2020. Multivariable analysis and spline analysis with a knot at COVID outbreak were performed to investigate the time trend and factors associated with ambulatory RALP and TURBT.
Results: Among 17,386 RALPs, 6,774 (39.0%) were ambulatory. Among 25,070 TURBTs, 21,573 (86.0%) were ambulatory. Pre-COVID, 33.5% of RALP and 85.3% and TURBT were ambulatory, which increased to 53.8% and 88.0% post-COVID (both p < 0.001). In multivariable model, RALP and TURBT performed after outbreak in March 2020 were more likely ambulatory (OR 2.31, p < 0.0001; OR 1.25, p < 0.0001). There was an overall increasing trend in use of ambulatory RALP both pre- and post-COVID, with no significant change of trend at the time of outbreak (p = 0.642). TURBT exhibited an increased shift towards ambulatory sites post-COVID (p < 0.0001).
Conclusions: We found a shift towards ambulatory RALP and TURBT following COVID outbreak. There was a large increase in ambulatory RALP post-COVID, but the trend of change was not significantly different pre- and post-COVID — possibly due to a pre-existing trend towards ambulatory RALP which predated the pandemic.

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