RETROPERITONEAL VERSUS TRANSPERITONEAL ROBOT-ASSISTED PARTIAL
NEPHRECTOMY FOR POSTERIOR RENAL TUMORS: A MATCHED PAIR
ANALYSIS
V. Ficarra, J. Porter, S. Bhayani, M. Sun, J. Bhardwa, R. Lee, G. Novara, M. Borghesi, G. De
Naeyer, A. Mottrie (Aalst, Belgium)
Aim of the study
No study compare retroperitoneal and transperitoneal approaches in patients who underwent
robot-assisted partial nephrectomy (RAPN). To perform a matched pair analysis to compare the
perioperative outcome of two contemporary series of patients receiving transperitoneal or
retroperitoneal RAPN for suspicious posterior renal tumors.
Materials and methods
We retrospectively analyzed the clinical records of patients who underwent retroperitoneal or
transperitoneal RAPN in three referral Centers from September 2006 to December 2010. Due to
inherent differences between patients undergoing retroperitoneal and transperitoneal RAPN in
terms of baseline patient and disease characteristics, we used 1:1 propensity-score matched
analyses to adjust for these differences. The following perioperative parameters were compared:
warm ischemia time (WIT), upper collecting system (UCS) repair, console time, blood loss,
intra- and postoperative complication rates.
Results
A total of 164 procedures were performed for posterior tumors. Propensity-score matching
resulted in a cohort of 44 transperitoneal and 44 retroperitoneal RAPN procedures. The median
warm ischemia time was 18.5 (IQR 15-22) min in the transperitoneal group and 19 (IQR 15-23)
min in the retroperitoneal ones (p=0.70). The median intraoperative blood loss was 100 ml (IQR
52-147) after transperitoneal approach and 50 ml (IQR 30-100) after retroperitoneal ones (p
Discussion
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Conclusions
This matched-pair analysis showed that retroperitoneal and transperitoneal approaches offer
similar perioperative outcomes in the treatment of posterior renal tumours. Therefore, the choice
of the best route should be based on the surgeon preference.