PD12-06 RETROPERITONEAL VS. TRANSPERITONEAL ROBOTIC PARTIAL NEPHRECTOMY FOR POSTERO-LATERAL RENAL MASSES: AN INTERNATIONAL MULTICENTER ANALYSIS

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I (PD12)1 Sep 2021PD12-06 RETROPERITONEAL VS. TRANSPERITONEAL ROBOTIC PARTIAL NEPHRECTOMY FOR POSTERO-LATERAL RENAL MASSES: AN INTERNATIONAL MULTICENTER ANALYSIS Umberto Carbonara, Umberto Capitanio, Daniel Eun, Ithaar Derweesh, Alessandro Larcher, Fabio Crocerossa, Lance Hampton, Francesco Montorsi, Francesco Porpiglia, and Riccardo Autorino Umberto CarbonaraUmberto Carbonara More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , Daniel EunDaniel Eun More articles by this author , Ithaar DerweeshIthaar Derweesh More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , Fabio CrocerossaFabio Crocerossa More articles by this author , Lance HamptonLance Hampton More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Francesco PorpigliaFrancesco Porpiglia More articles by this author , and Riccardo AutorinoRiccardo Autorino More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001987.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Over the last ten years, robot-assisted partial nephrectomy (RAPN) has rapidly become the preferred minimally invasive surgical treatment for localized renal tumors. Historically, RAPN has been preferably performed with a transperitoneal approach. Nevertheless, retroperitoneal RAPN (r-RAPN) represents an attractive alternative, especially for posterior or lateral renal masses as it allows immediate access to the kidney, minimizing the risk of ileus and/or potential complications related to bowel mobilization, and avoiding intraabdominal adhesions in patients with previous abdominal surgery. The aim of the present abstract was to assess the outcomes of r-RAPN in a large cohort of patients with postero-lateral renal masses comparing these results versus those of 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. When normally distributed, mean ± standard deviation (SD) was used. Instead, median and interquartile range (IQR) was adopted to report not-normal distribution data. Frequency (%) was used in categorical data. t-test or Kruskal-Wallis H test was applied to compare the differences in the distribution of continuous variables. For categorical variables, the Pearson Chi-Squared or Fishers’ exact test was used to test the differences. 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. 170min, 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 readmission rate (2.5 vs. 3, p=0.2), median length of stay (2 vs. 2days, p=0.7), and PSM rate (3 vs. 2.5%, p=0.2) between r-RAPN and t-RAPN groups. Trifecta criteria were achieved in 90.3 and 89.2% of r-RAPN and t-RAPN, respectively (p=0.7). CONCLUSIONS: r-RAPN and t-RAPN offer similar postoperative, functional, and oncological outcomes for patients with posterior-later located renal tumor. 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. Source of Funding: No funding © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e205-e205 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Umberto Carbonara More articles by this author Umberto Capitanio More articles by this author Daniel Eun More articles by this author Ithaar Derweesh More articles by this author Alessandro Larcher More articles by this author Fabio Crocerossa More articles by this author Lance Hampton More articles by this author Francesco Montorsi More articles by this author Francesco Porpiglia More articles by this author Riccardo Autorino More articles by this author Expand All Advertisement Loading ...