MP49-06 A HELPFUL TOOL IN THE RENAL SURGERY ARMAMENTARIUM: DORSAL LUMBOTOMY NEPHRECTOMY FOR TUMOR IN PATIENTS WITH END-STAGE RENAL DISEASE

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (MP49)1 Sep 2021MP49-06 A HELPFUL TOOL IN THE RENAL SURGERY ARMAMENTARIUM: DORSAL LUMBOTOMY NEPHRECTOMY FOR TUMOR IN PATIENTS WITH END-STAGE RENAL DISEASE Ian Cooke, Samiha Sadruddin, Dattatraya Patil, Satyen Tripathi, Reza Nabavizadeh, Kenneth Ogan, and Viraj Master Ian CookeIan Cooke More articles by this author , Samiha SadruddinSamiha Sadruddin More articles by this author , Dattatraya PatilDattatraya Patil More articles by this author , Satyen TripathiSatyen Tripathi More articles by this author , Reza NabavizadehReza Nabavizadeh More articles by this author , Kenneth OganKenneth Ogan More articles by this author , and Viraj MasterViraj Master More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002075.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The dorsolumbar (DL) approach to the kidney was first described in 1870 but remains an infrequently utilized approach today, with little data comparing it to contemporary approaches. The purpose of our study was to compare operative outcomes between the DL and laparoscopic (LN) approaches for patients with end stage renal disease (ESRD) undergoing nephrectomy. DL operative technique is also described. METHODS: We performed a retrospective review of patients undergoing DL nephrectomy at our institution from 2008-2020. Cases were matched with controls who had undergone LN. Outcome parameters included operative time, estimated blood loss (EBL), length of stay (LOS), postoperative narcotic requirements, and complication rates. Statistical analysis performed with SPSS. RESULTS: 43 DL patients and 86 LN patients were assessed. DL had shorter total OR time (173min vs 198min; p=0.001) and surgery time (101min vs 135min; p<0.001) compared to LN. There was a trend towards decreased mean LOS among the DL group (2.65d vs 3.14d; p=0.069) as well as narcotic requirement measured in oral morphine equivalents (54.8mg/day vs 73.6mg/day, p=0.051). There were no differences in EBL, complication rates, or 30-day readmissions. Limitations include retrospective design and sample size. CONCLUSIONS: Our study is the first to perform a matched comparison of DL and LN approaches to nephrectomy in patients with ESRD. We found DL to be safe and effective compared to LN, with shorter operative times, a trend towards decreased LOS and post-operative narcotic requirements, and similar complication rates. DL should be considered as an approach for nephrectomy in appropriately selected patients in this population. Source of Funding: John Robinson Family Foundation, Christopher Churchill Foundation © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e876-e877 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ian Cooke More articles by this author Samiha Sadruddin More articles by this author Dattatraya Patil More articles by this author Satyen Tripathi More articles by this author Reza Nabavizadeh More articles by this author Kenneth Ogan More articles by this author Viraj Master More articles by this author Expand All Advertisement Loading ...