Skip to main content
SpringerLink
Log in

Transperitoneal versus retroperitoneal robotic partial nephrectomy: matched-pair comparisons by nephrometry scores

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to compare perioperative outcomes of transperitoneal (TP) and retroperitoneal (RP) robot-assisted partial nephrectomy (RPN) by matched analysis using nephrometry systems.

Methods

A total of 107 patients who underwent RPN by a single surgeon from December 2008 to June 2012 were analyzed; 57 patients underwent TP RPN and 50 patients underwent RP RPN. Baseline demographic characteristics, perioperative outcomes and changes in renal function were collected by retrospective review of medical records. Matched-pair comparisons were done using RENAL score and C-index.

Results

No significant difference was observed between TP and RP RPN in patient age, body mass index, gender, laterality, clinical stage, tumor size, RENAL score or ASA score. The TP RPN had more cystic renal masses (TP vs. RP = 33 vs. 12 %, p = 0.012) and RP RPN had shorter median operation times (150 vs. 120 min, p = 0.015) and shorter mean warm ischemic times (26.2 vs. 22.6 min, p = 0.040) than TP RPN. In the matched-pair analysis, RP RPN showed shorter operation times with similar warm ischemic times. Estimated blood loss and visual analog pain scales showed no significant differences between groups. A total of 12 (11.4 %) postoperative complications occurred, all Clavien class I or II with no significant difference in incidence.

Conclusions

Retroperitoneal robot-assisted partial nephrectomy showed shorter operation time and generally equivalent perioperative results to TP RPN. RP RPN is a viable treatment option for treating posterior or lateral renal masses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Lee SY, Choi JD, Seo SI (2011) Current status of partial nephrectomy for renal mass. Korean J Urol 52:301–309. doi:10.4111/kju.2011.52.5.301

    Article  PubMed Central  PubMed  Google Scholar 

  2. Campbell SC, Novick AC, Belldegrun A, Blute ML, Chow GK, Derweesh IH, Faraday MM, Kaouk JH, Leveillee RJ, Matin SF, Russo P, Uzzo RG, Practice Guidelines Committee of the American Urological A (2009) Guideline for management of the clinical T1 renal mass. J Urol 182:1271–1279. doi:10.1016/j.juro.2009.07.004

    Article  PubMed  Google Scholar 

  3. Kieran K, Montgomery JS, Daignault S, Roberts WW, Wolf JS Jr (2007) Comparison of intraoperative parameters and perioperative complications of retroperitoneal and transperitoneal approaches to laparoscopic partial nephrectomy: support for a retroperitoneal approach in selected patients. J Endourol 21:754–759. doi:10.1089/end.2007.0337

    Article  PubMed  Google Scholar 

  4. Wright JL, Porter JR (2005) Laparoscopic partial nephrectomy: comparison of transperitoneal and retroperitoneal approaches. J Urol 174:841–845. doi:10.1097/01.ju.0000169423.94253.46

    Article  PubMed  Google Scholar 

  5. Marszalek M, Chromecki T, Al-Ali BM, Meixl H, Madersbacher S, Jeschke K, Pummer K, Zigeuner R (2011) Laparoscopic partial nephrectomy: a matched-pair comparison of the transperitoneal versus the retroperitoneal approach. Urology 77:109–113. doi:10.1016/j.urology.2010.02.057

    Article  PubMed  Google Scholar 

  6. Fan X, Xu K, Lin T, Liu H, Yin Z, Dong W, Huang H, Huang J (2013) Comparison of transperitoneal and retroperitoneal laparoscopic nephrectomy for renal cell carcinoma: a systematic review and meta-analysis. BJU Int 111:611–621. doi:10.1111/j.1464-410X.2012.11598.x

    Article  PubMed  Google Scholar 

  7. Benway BM, Bhayani SB, Rogers CG, Dulabon LM, Patel MN, Lipkin M, Wang AJ, Stifelman MD (2009) Robot assisted partial nephrectomy versus laparoscopic partial nephrectomy for renal tumors: a multi-institutional analysis of perioperative outcomes. J Urol 182:866–872. doi:10.1016/j.juro.2009.05.037

    Article  PubMed  Google Scholar 

  8. Ellison JS, Montgomery JS, Wolf JS Jr, Hafez KS, Miller DC, Weizer AZ (2012) A matched comparison of perioperative outcomes of a single laparoscopic surgeon versus a multisurgeon robot-assisted cohort for partial nephrectomy. J Urol 188:45–50. doi:10.1016/j.juro.2012.02.2570

    Article  PubMed  Google Scholar 

  9. Weizer AZ, Palella GV, Montgomery JS, Miller DC, Hafez KS (2011) Robot-assisted retroperitoneal partial nephrectomy: technique and perioperative results. J Endourol 25:553–557

    Article  PubMed  Google Scholar 

  10. Benway BM, Wang AJ, Cabello JM, Bhayani SB (2009) Robotic partial nephrectomy with sliding-clip renorrhaphy: technique and outcomes. Eur Urol 55:592–599. doi:10.1016/j.eururo.2008.12.028

    Article  PubMed  Google Scholar 

  11. Patel M, Porter J (2013) Robotic retroperitoneal partial nephrectomy. World J Urol 31:1377–1382. doi:10.1007/s00345-013-1038-y

    Article  PubMed  Google Scholar 

  12. Choi JD, Park JW, Choi JY, Kim HS, Jeong BC, Jeon SS, Lee HM, Choi HY, Seo SI (2010) Renal damage caused by warm ischaemia during laparoscopic and robot-assisted partial nephrectomy: an assessment using Tc 99 m-DTPA glomerular filtration rate. Eur Urol 58:900–905. doi:10.1016/j.eururo.2010.08.044

    Article  PubMed  Google Scholar 

  13. Bhayani SB, Das N (2008) Robotic assisted laparoscopic partial nephrectomy for suspected renal cell carcinoma: retrospective review of surgical outcomes of 35 cases. BMC Surg 8:16. doi:10.1186/1471-2482-8-16

    Article  PubMed Central  PubMed  Google Scholar 

  14. Cabello JM, Benway BM, Bhayani SB (2009) Robotic-assisted partial nephrectomy: surgical technique using a 3-arm approach and sliding-clip renorrhaphy. Int Braz J Urol 35:199–203 discussion 203–204

    Article  PubMed  Google Scholar 

  15. Kutikov A, Uzzo RG (2009) The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol 182:844–853

    Article  PubMed  Google Scholar 

  16. Simmons MN, Ching CB, Samplaski MK, Park CH, Gill IS (2010) Kidney tumor location measurement using the C index method. J Urol 183:1708–1713

    Article  PubMed  Google Scholar 

  17. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed Central  PubMed  Google Scholar 

  18. National Kidney F (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39:S1–S266

    Google Scholar 

  19. Hughes-Hallett A, Patki P, Patel N, Barber NJ, Sullivan M, Thilagarajah R (2013) Robot-assisted partial nephrectomy: a comparison of the transperitoneal and retroperitoneal approaches. J Endourol 27:869–874. doi:10.1089/end.2013.0023

    Article  PubMed  Google Scholar 

  20. Ng CS, Gill IS, Ramani AP, Steinberg AP, Spaliviero M, Abreu SC, Kaouk JH, Desai MM (2005) Transperitoneal versus retroperitoneal laparoscopic partial nephrectomy: patient selection and perioperative outcomes. J Urol 174:846–849

    Article  PubMed  Google Scholar 

  21. Benway BM, Bhayani SB (2010) Robot-assisted partial nephrectomy: evolution and recent advances. Curr Opin Urol 20:119–124

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

None.

Conflict of interest

The authors declare that there is no conflict of interest.

Ethical standard

This study protocol was approved by the institutional review board of the Samsung Medical Center (IRB approval 2013-01-069) and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Informed consent was waived by IRB.

Author information

Authors and Affiliations

  1. Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea

    Seol Ho Choo, Hyun Hwan Sung, Hwang Gyun Jeon, Byong Chang Jeong, Seong Soo Jeon, Hyun Moo Lee, Han Yong Choi & Seong Il Seo

  2. Department of Urology, Ajou University School of Medicine, Suwon, Korea

    Seol Ho Choo

  3. Department of Urology, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea

    Seo Yeon Lee

Authors
  1. Seol Ho Choo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seo Yeon Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hyun Hwan Sung
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hwang Gyun Jeon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Byong Chang Jeong
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Seong Soo Jeon
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hyun Moo Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Han Yong Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Seong Il Seo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seong Il Seo.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Choo, S.H., Lee, S.Y., Sung, H.H. et al. Transperitoneal versus retroperitoneal robotic partial nephrectomy: matched-pair comparisons by nephrometry scores. World J Urol 32, 1523–1529 (2014). https://doi.org/10.1007/s00345-014-1312-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-014-1312-7

Keywords

Search

Navigation