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- Title
Retroperitoneal versus transepritoneal robot-assisted partial nephrectomy for postero-lateral renal masses: an international multicenter analysis.
- Authors
Carbonara, Umberto; Eun, Daniel; Derweesh, Ithaar; Capitanio, Umberto; Celia, Antonio; Fiori, Cristian; Checcucci, Enrico; Amparore, Daniele; Lee, Jennifer; Larcher, Alessandro; Patel, Devin; Meagher, Margaret; Crocerossa, Fabio; Veccia, Alessandro; Hampton, Lance J.; Montorsi, Francesco; Porpiglia, Francesco; Autorino, Riccardo
- Abstract
Purpose: To assess the outcomes of retroperitoneal robot-assisted partial nephrectomy (r-RAPN) in a large cohort of patients with postero-lateral renal masses comparing to those of transperitoneal RAPN (t-RAPN). Methods: Patients with posterior (R.E.N.A.L. score grading P) or lateral (grading X) renal mass who underwent RAPN in six high-volume US and European centers were identified and stratified into two groups according to surgical approach: r-RAPN ("study group") and t-RAPN ("control group"). Baseline characteristics, intraoperative, and postoperative data were collected and compared. Results: Overall, 447 patients were identified for the analysis. 231 (51.7%) and 216 (48.3%) patients underwent r-RAPN and t-RAPN, respectively. Baseline characteristics were not statistically significantly different between the groups. r-RAPN group reported lower median operative time (140 vs. 170 min, p < 0.001). No difference was found in ischemia time, estimated blood loss, and intraoperative complications. Overall, 47 and 54 postoperative complications were observed in r-RAPN and t-RAPN groups, respectively (20.3 vs. 25.1%, p = 0.9). 1 and 2 patients reported major complications (Clavien-Dindo ≥ III grade) in the retroperitoneal and transperitoneal groups (0.4 vs. 0.9%, p = 0.9). There was no difference in hospital re-admission rate, median length of stay, and PSM rate. Trifecta criteria were achieved in 90.3 and 89.2% of r-RAPN and t-RAPN, respectively (p = 0.7). Conclusion: r-RAPN and t-RAPN offer similar postoperative, functional, and oncological outcomes for patients with postero-lateral renal tumors. Our analysis suggests an advantage for r-RAPN in terms of shorter operative time, whereas it does not confirm a difference in terms of length of stay, as suggested by previous reports.
- Subjects
NEPHRECTOMY; SURGICAL robots; SURGICAL complications; TREATMENT effectiveness; KIDNEY tumors; RATINGS of hospitals
- Publication
World Journal of Urology, 2021, Vol 39, Issue 11, p4175
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-021-03741-2