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Safety and efficacy of laparoscopic transperitoneal versus retroperitoneal resection for benign retroperitoneal tumors: a retrospective cohort study

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Abstract

Background and objective

Benign retroperitoneal tumors (BRTs) are clinically rare solid tumors. This study aimed to compare the safety and efficacy of laparoscopic transperitoneal versus retroperitoneal resection for BRTs.

Methods

The clinical data of 43 patients who had pathologically confirmed BRTs and underwent laparoscopic resection in a single center from January 2019 to May 2022 were retrospectively analyzed. Patients were divided into two groups according to the surgical methods: the Transperitoneal approach group (n = 24) and the Retroperitoneal approach group (n = 19). The clinical characteristics and perioperative data between the two groups were compared. The baseline data and surgical variables were analyzed to determine the impact of different surgical approaches on the treatment outcomes of BRTs.

Results

No significant difference was observed between the two groups in gender, age, body mass index, the American Society of Anesthesiologists score, presence of underlying diseases, tumor size, tumor position, operation duration, intraoperative hemorrhage, postoperative hospital stay, intestinal function recovery time, and postoperative complication rate. The conversion rate from laparoscopic to open surgery was significantly lower in the Transperitoneal approach group than in the Retroperitoneal approach group (1/24 vs. 5/19, χ2 = 4.333, P = 0.037). Tumor size was an independent influencing factor for the effect of surgery (odds ratio = 1.869, 95% confidence interval = 1.135–3.078, P = 0.014) and had a larger efficacy on the retroperitoneal group (odds ratio = 3.740, 95% confidence interval = 1.044–13.394, P = 0.043).

Conclusion

The laparoscopic transperitoneal approach has the inherent advantages of anatomical hierarchies and surgical space, providing a better optical perspective of the targeted mass and improved bleeding control. This approach may have better efficacy than the retroperitoneal approach, especially in cases of a large tumor or when the tumor is located near important blood vessels.

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Data availability

The raw data supporting the conclusions of this manuscript will be made available by the corresponding author, without undue reservation, to any qualified researcher.

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Acknowledgements

We thank everyone, who supports us to finish this study.

Funding

This work was supported by grants from the National multidisciplinary collaborative diagnosis and treatment capacity building project for major diseases (Grant No. TJZ202104), the Natural Science Foundation of China (Grant Nos. 82270643, 82070644 and 82170621), the Science and Technology Major Program of Sichuan Province (Grant No. 2022ZDZX0019), 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (Grant Nos. ZYJC18008, ZYGD22006).

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Author notes

  1. Ziqi Hou and Qingyun Xie have contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Division of Liver Surgery, Department of General Surgery and Laboratory of Liver Surgery, State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, 610041, Sichuan Province, China

    Ziqi Hou, Qingyun Xie, Guoteng Qiu, Zhaoxing Jin, Shizheng Mi, Chang Liu & Jiwei Huang

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  1. Ziqi Hou
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Contributions

QX, ZH, CL, JH: Guarantor of integrity of the entire study, Study concepts, Study design, Manuscript preparation—editing—review, and Definition of intellectual content. QX, ZH, GQ, ZJ, SM: Literature research, Clinical studies, Experimental studies, and Data acquisition. QX, ZH: Data analysis and Statistical analysis.

Corresponding authors

Correspondence to Chang Liu or Jiwei Huang.

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Disclosures

Ziqi Hou, Qingyun Xie, Guoteng Qiu, Zhaoxing Jin, Shizheng Mi, Chang Liu and Jiwei Huang have no conflicts of interest or financial ties to disclose.

Ethical approval

This study was approved by the Ethics Review Committee of the West China Hospital.

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Hou, Z., Xie, Q., Qiu, G. et al. Safety and efficacy of laparoscopic transperitoneal versus retroperitoneal resection for benign retroperitoneal tumors: a retrospective cohort study. Surg Endosc 37, 9299–9309 (2023). https://doi.org/10.1007/s00464-023-10504-0

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  • DOI: https://doi.org/10.1007/s00464-023-10504-0

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