Transperitoneal Versus Retroperitoneal Single-port Robotic-assisted Partial Nephrectomy: An Analysis from the Single Port Advanced Research Consortium

被引:14
作者
Rich, Jordan M. [1 ]
Okhawere, Kennedy E. [1 ]
Nguyen, Charles [1 ]
Ucpinar, Burak [1 ]
Zuluaga, Laura [1 ]
Razdan, Shirin [1 ]
Saini, Indu [1 ]
Beksac, Alp Tuna [2 ]
Nguyen, Jennifer [3 ]
Calvo, Ruben S. [4 ]
Ahmed, Mutahar [3 ]
Mehrazin, Reza [1 ]
Abaza, Ronney [5 ]
Stifelman, Michael D.
Kaouk, Jihad [2 ]
Crivellaro, Simone [4 ]
Badani, Ketan K. [1 ,6 ]
机构
[1] Icahn Sch Med Mt Sinai, New York, NY USA
[2] Cleveland Clin, Glickman Urol & Kidney Inst, Cleveland, OH USA
[3] Hackensack Univ, Med Ctr, Hackensack, NJ USA
[4] Univ Illinois, Dept Urol, Chicago, IL USA
[5] Cent Ohio Urol Grp, Columbus, OH USA
[6] Icahn Sch Med Mt Sinai, Dept Urol, 1425 Madison Ave,6th Floor, New York, NY 10029 USA
关键词
Kidney cancer; Partial nephrectomy; Minimal invasive surgery; Single port; Retroperitoneal; Robotic; EXTRAPERITONEAL; OUTCOMES;
D O I
10.1016/j.euf.2023.06.004
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: In the surgical management of kidney tumors, such as in multiport technology, single-port (SP) robotic-assisted partial nephrectomy (RAPN) can be performed using the transperitoneal (TP) or retroperitoneal (RP) approach. However, there is a dearth of literature on the efficacy and safety of either approach for SP RAPN.Objective: To compare the peri- and postoperative outcomes of the TP and RP approaches for SP RAPN.Design, setting, and participantsThis is a retrospective cohort study using data from the Single Port Advanced Research Consortium (SPARC) database of five institutions. All patients underwent SP RAPN for a renal mass between 2019 and 2022.Intervention: TP versus RP SP RAPN.Outcome measurements and statistical analysis: Baseline characteristics, and peri- and postoperative outcomes were compared between both the approaches using chi(2) test, Fisher exact test, Mann-Whitney U test, and Student t test.Results and limitations: A total of 219 patients (121 [55.25%] TP, 98 [44.75%] RP) were included in the study. Of them, 115 (51.51%) were male, and the mean age was 60 +/- 11 yr. RP had a significantly higher proportion of posterior tumors (54 [55.10%] RP vs 28 [23.14%] TP, p < 0.001), while other baseline characteristics were comparable between both the approaches. There was no statistically significant difference in ischemia time (18 +/- 9 vs 18 +/- 11 min, p = 0.898), operative time (147 +/- 67 vs 146 +/- 70 min, p = 0.925), estimated blood loss (p = 0.167), length of stay (1.06 +/- 2.25 vs 1.33 +/- 1.05 d, p = 0.270), overall complications (5 [5.10%] vs 7 [5.79%]), and major complication rate (2 [2.04%] vs 2 [1.65%], p = 1.000). No difference was observed in positive surgical margin rate (p = 0.472) or delta eGFR at median 6-mo follow-up (p = 0.273). Limitations include retrospective design and no long-term follow-up.Conclusions: With proper patient selection based on patient and tumor characteristics, surgeons can opt for either the TP or the RP approach for SP RAPN, and maintain satisfactory outcomes.
引用
收藏
页码:1059 / 1064
页数:6
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