PD41-04 TRANSPERITONEAL APPROACH ACHIEVES SIMILAR OUTCOMES TO RETROPERITONEAL APPROACH FOR POSTERIOR TUMORS

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV1 Apr 2016PD41-04 TRANSPERITONEAL APPROACH ACHIEVES SIMILAR OUTCOMES TO RETROPERITONEAL APPROACH FOR POSTERIOR TUMORS Matthew J. Maurice, Jihad H. Kaouk, Peter A. Caputo, Ravi Barod, Sam B. Bhayani, Mohamad E. Allaf, Craig G. Rogers, and Michael D. Stifelman Matthew J. MauriceMatthew J. Maurice More articles by this author , Jihad H. KaoukJihad H. Kaouk More articles by this author , Peter A. CaputoPeter A. Caputo More articles by this author , Ravi BarodRavi Barod More articles by this author , Sam B. BhayaniSam B. Bhayani More articles by this author , Mohamad E. AllafMohamad E. Allaf More articles by this author , Craig G. RogersCraig G. Rogers More articles by this author , and Michael D. StifelmanMichael D. Stifelman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1550AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The best approach for treating posterior renal tumors by robotic partial nephrectomy (RPN) is controversial. We sought to compare surgical outcomes for posterior tumors treated by RPN using either a transperitoneal approach (TA) or a retroperitoneal approach (RA). METHODS Using a retrospective multicenter RPN database from five high-volume surgeons, we abstracted data on consecutive patients treated between 2007 and 2015. The study cohort was limited to posterior renal masses. The primary outcomes were complication rate, transfusion rate, positive margin rate, estimated blood loss (EBL), operative time, and warm ischemia time. Other explanatory variables considered included age, sex, race, American Society of Anesthesiologists (ASA) score, body mass index, tumor size, RENAL score, and pathologic tumor stage. Univariate analysis was performed using the chi-square test or Fisher′s exact test for categorical variables, the Spearman correlation for continuous variables, and the Mann-Whitney U test for mixed variables. Multivariate analysis was performed using multiple linear regression. RESULTS Of 610 RPN cases for posterior renal masses, 87 (14.3%) were performed using a RA. Mean EBL was 190±221 ml for the TA and 149±62 ml for the RA (p=.04). After adjusting for covariates on multivariate analysis, RPN approach was no longer a significant predictor of EBL (p=.14). The rates of overall complications (16.1% vs. 10.3%, p=.17), major complications (5.0% vs. 4.6%, p=.88), transfusion (5.5% vs. 2.3%, p=.29), and positive margins (2.0% vs. 2.4%, p=.79) were not significantly different for the TA vs. the RA, respectively. Mean operative time was 180±59 for the TA and 169±58 minutes for the RA (p=.06). Warm ischemia time was 19±8.6 minutes for the TA vs. 21±6.8 minutes for the RA (p =.07). CONCLUSIONS At high-volume centers, the transperitoneal vs. retroperitoneal approach is not significantly associated with surgical outcomes after RPN for posteriorly located renal masses. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e941 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Matthew J. Maurice More articles by this author Jihad H. Kaouk More articles by this author Peter A. Caputo More articles by this author Ravi Barod More articles by this author Sam B. Bhayani More articles by this author Mohamad E. Allaf More articles by this author Craig G. Rogers More articles by this author Michael D. Stifelman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...