MP42-03 COMPARISON OF KIDNEY FUNCTION IN THE EARLY POSTOPERATIVE PERIOD BETWEEN A TRANSPERITONEAL VERSUS RETROPERITONEAL ROBOT-ASSISTED LAPAROSCOPIC PARTIAL NEPHRECTOMY FOR POSTERIOR RENAL TUMORS: A PROPENSITY SCORE-MATCHED STUDY

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV1 Apr 2018MP42-03 COMPARISON OF KIDNEY FUNCTION IN THE EARLY POSTOPERATIVE PERIOD BETWEEN A TRANSPERITONEAL VERSUS RETROPERITONEAL ROBOT-ASSISTED LAPAROSCOPIC PARTIAL NEPHRECTOMY FOR POSTERIOR RENAL TUMORS: A PROPENSITY SCORE-MATCHED STUDY Toshio Takagi, Tsunenori Kondo, Kazuhiko Yoshida, Junpei Iizuka, Hirohito Kobayashi, Masayoshi Okumi, Hideki Ishida, and Kazunari Tanabe Toshio TakagiToshio Takagi More articles by this author , Tsunenori KondoTsunenori Kondo More articles by this author , Kazuhiko YoshidaKazuhiko Yoshida More articles by this author , Junpei IizukaJunpei Iizuka More articles by this author , Hirohito KobayashiHirohito Kobayashi More articles by this author , Masayoshi OkumiMasayoshi Okumi More articles by this author , Hideki IshidaHideki Ishida More articles by this author , and Kazunari TanabeKazunari Tanabe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1310AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We have previously reported that posterior tumors showed a greater decrease in the early postoperative estimated glomerular filtration rate (eGFR) than anterior tumors, with equivalent renal function 6-12 months following a transperitoneal robot-assisted laparoscopic partial nephrectomy (RAPN). Although the reason for this result remains unclear, ischemic injury occurring during mobilization of the kidney for management of posterior tumors might explain this finding. Our present study compared early postoperative kidney function between transperitoneal and retroperitoneal RAPN for the management of posterior renal tumors. METHODS Our study included 156 patients who underwent transperitoneal or retroperitoneal RAPN to treat posterior renal tumors. Early postoperative eGFR was evaluated on postoperative day 1-7. Patient variables were adjusted using 1:1 propensity score matching to minimize a selection bias between the transperitoneal and retroperitoneal approach. RESULTS Among 156 patients, 118 patients were performed by the transperitoneal approach and 38 were performed by the retroperitoneal approach. After matching, each group included 34 patients. The decrease in early postoperative eGFR (-10% vs. -1.4%, p = 0.0348) was observed to be significantly higher using the transperitoneal than the retroperitoneal approach. Additionally, surgical time (172 min vs. 144 min, p = 0.001) and console time (126 min vs. 92 min, p < 0.0001) were significantly longer using the transperitoneal approach. Other surgical outcomes did not significantly differ between the groups. Multivariate analysis of the entire cohort showed that the transperitoneal vs. retroperitoneal approach (odds ratio [OR] 5.64, p = 0.0024) was an independent predictor of the development of a 15% decrease in early postoperative eGFR, even if other factors (warm ischemia time, tumor size, and tumor complexity) were not statistically significant. CONCLUSIONS A retroperitoneal approach showed better surgical outcomes including a lesser decrease in the early postoperative eGFR and a shorter operative and console time than the retroperitoneal approach used for RAPN to treat posterior tumors. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e536-e537 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Toshio Takagi More articles by this author Tsunenori Kondo More articles by this author Kazuhiko Yoshida More articles by this author Junpei Iizuka More articles by this author Hirohito Kobayashi More articles by this author Masayoshi Okumi More articles by this author Hideki Ishida More articles by this author Kazunari Tanabe More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...