Comparison of Transperitoneal and Retroperitoneal Robotic Partial Nephrectomy for Patients with Completely Lower Pole Renal Tumors
(1) Background: For completely lower pole renal tumors, we compared the perioperative outcomes of robotic partial nephrectomy via transperitoneal and retroperitoneal approaches. (2) Methods: Complete lower pole renal tumors were defined as tumors that received 1 point for the “L” element of the R.E....
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MDPI AG
2023-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/2/722 |
| _version_ | 1797440570685128704 |
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| author | Wenlei Zhao Yancai Ding Dong Chen Yundong Xuan Zhiqiang Chen Xupeng Zhao Bin Jiang Baojun Wang Hongzhao Li Chengliang Yin Xin Ma Gang Guo Liangyou Gu Xu Zhang |
| author_facet | Wenlei Zhao Yancai Ding Dong Chen Yundong Xuan Zhiqiang Chen Xupeng Zhao Bin Jiang Baojun Wang Hongzhao Li Chengliang Yin Xin Ma Gang Guo Liangyou Gu Xu Zhang |
| author_sort | Wenlei Zhao |
| collection | DOAJ |
| description | (1) Background: For completely lower pole renal tumors, we compared the perioperative outcomes of robotic partial nephrectomy via transperitoneal and retroperitoneal approaches. (2) Methods: Complete lower pole renal tumors were defined as tumors that received 1 point for the “L” element of the R.E.N.A.L. and located at the lower pole of kidney. After confirming consistency in baseline characteristics, oncological and functional benefits were compared. Pentafecta achievement was used to represent the perioperative optimal outcome, followed by multivariate analysis of factors associated with the lack of pentafecta achievement. (3) Results: Among 151 patients identified, 116 (77%) underwent robotic partial nephrectomy via a transperitoneal approach and 35 (23%) via a retroperitoneal approach. Patients undergoing transperitoneal robotic partial nephrectomy experienced more blood loss than those undergoing retroperitoneal robotic partial nephrectomy (50 mL vs. 40 mL, <i>p</i> = 0.015). No significant differences were identified for operative time (120 min vs. 120 min), ischemia time (19 min vs. 20 min), positive surgical margins (0.0% vs. 2.86%), postoperative rate of complication (12.07% vs. 5.71%). No significant differences were identified in pathologic variables, eGFR decline in postoperative 12-month (3.9% vs. 5.4%) functional follow-up. Multivariate cox analysis showed that tumor size (OR: 0.523; 95% CI: 0.371–0.736; <i>p</i> < 0.001) alone was independently correlated to the achievement of pentafecta. (4) Conclusions: For completely lower pole renal tumors, transperitoneal and retroperitoneal robotic partial nephrectomy provide similar outcomes. These two surgical approaches remain feasible options for these cases. |
| first_indexed | 2024-03-09T12:10:05Z |
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| id | doaj.art-e6cff201a1b94afb9567e5d2c84bb72a |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T12:10:05Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-e6cff201a1b94afb9567e5d2c84bb72a2023-11-30T22:53:57ZengMDPI AGJournal of Clinical Medicine2077-03832023-01-0112272210.3390/jcm12020722Comparison of Transperitoneal and Retroperitoneal Robotic Partial Nephrectomy for Patients with Completely Lower Pole Renal TumorsWenlei Zhao0Yancai Ding1Dong Chen2Yundong Xuan3Zhiqiang Chen4Xupeng Zhao5Bin Jiang6Baojun Wang7Hongzhao Li8Chengliang Yin9Xin Ma10Gang Guo11Liangyou Gu12Xu Zhang13Department of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Urology, Chinese PLA NO. 942 Hospital, Yinchuan 750003, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing 100853, ChinaMedical School, Nankai University, Tianjin 300071, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing 100853, ChinaNational Engineering Laboratory for Medical Big Data Application Technology, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing 100853, China(1) Background: For completely lower pole renal tumors, we compared the perioperative outcomes of robotic partial nephrectomy via transperitoneal and retroperitoneal approaches. (2) Methods: Complete lower pole renal tumors were defined as tumors that received 1 point for the “L” element of the R.E.N.A.L. and located at the lower pole of kidney. After confirming consistency in baseline characteristics, oncological and functional benefits were compared. Pentafecta achievement was used to represent the perioperative optimal outcome, followed by multivariate analysis of factors associated with the lack of pentafecta achievement. (3) Results: Among 151 patients identified, 116 (77%) underwent robotic partial nephrectomy via a transperitoneal approach and 35 (23%) via a retroperitoneal approach. Patients undergoing transperitoneal robotic partial nephrectomy experienced more blood loss than those undergoing retroperitoneal robotic partial nephrectomy (50 mL vs. 40 mL, <i>p</i> = 0.015). No significant differences were identified for operative time (120 min vs. 120 min), ischemia time (19 min vs. 20 min), positive surgical margins (0.0% vs. 2.86%), postoperative rate of complication (12.07% vs. 5.71%). No significant differences were identified in pathologic variables, eGFR decline in postoperative 12-month (3.9% vs. 5.4%) functional follow-up. Multivariate cox analysis showed that tumor size (OR: 0.523; 95% CI: 0.371–0.736; <i>p</i> < 0.001) alone was independently correlated to the achievement of pentafecta. (4) Conclusions: For completely lower pole renal tumors, transperitoneal and retroperitoneal robotic partial nephrectomy provide similar outcomes. These two surgical approaches remain feasible options for these cases.https://www.mdpi.com/2077-0383/12/2/722kidney neoplasmslower polepartial nephrectomyoutcomerobotics |
| spellingShingle | Wenlei Zhao Yancai Ding Dong Chen Yundong Xuan Zhiqiang Chen Xupeng Zhao Bin Jiang Baojun Wang Hongzhao Li Chengliang Yin Xin Ma Gang Guo Liangyou Gu Xu Zhang Comparison of Transperitoneal and Retroperitoneal Robotic Partial Nephrectomy for Patients with Completely Lower Pole Renal Tumors Journal of Clinical Medicine kidney neoplasms lower pole partial nephrectomy outcome robotics |
| title | Comparison of Transperitoneal and Retroperitoneal Robotic Partial Nephrectomy for Patients with Completely Lower Pole Renal Tumors |
| title_full | Comparison of Transperitoneal and Retroperitoneal Robotic Partial Nephrectomy for Patients with Completely Lower Pole Renal Tumors |
| title_fullStr | Comparison of Transperitoneal and Retroperitoneal Robotic Partial Nephrectomy for Patients with Completely Lower Pole Renal Tumors |
| title_full_unstemmed | Comparison of Transperitoneal and Retroperitoneal Robotic Partial Nephrectomy for Patients with Completely Lower Pole Renal Tumors |
| title_short | Comparison of Transperitoneal and Retroperitoneal Robotic Partial Nephrectomy for Patients with Completely Lower Pole Renal Tumors |
| title_sort | comparison of transperitoneal and retroperitoneal robotic partial nephrectomy for patients with completely lower pole renal tumors |
| topic | kidney neoplasms lower pole partial nephrectomy outcome robotics |
| url | https://www.mdpi.com/2077-0383/12/2/722 |
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