دورية أكاديمية
Transperitoneal Versus Retroperitoneal Single-port Robotic-assisted Partial Nephrectomy: An Analysis from the Single Port Advanced Research Consortium.
| العنوان: | Transperitoneal Versus Retroperitoneal Single-port Robotic-assisted Partial Nephrectomy: An Analysis from the Single Port Advanced Research Consortium. |
|---|---|
| المؤلفون: | Rich JM; Icahn School of Medicine at Mount Sinai, New York, NY, USA., Okhawere KE; Icahn School of Medicine at Mount Sinai, New York, NY, USA., Nguyen C; Icahn School of Medicine at Mount Sinai, New York, NY, USA., Ucpinar B; Icahn School of Medicine at Mount Sinai, New York, NY, USA., Zuluaga L; Icahn School of Medicine at Mount Sinai, New York, NY, USA., Razdan S; Icahn School of Medicine at Mount Sinai, New York, NY, USA., Saini I; Icahn School of Medicine at Mount Sinai, New York, NY, USA., Tuna Beksac A; Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA., Nguyen J; Hackensack University Medical Center, Hackensack, NJ, USA., Calvo RS; Department of Urology, University of Illinois, Chicago, IL, USA., Ahmed M; Hackensack University Medical Center, Hackensack, NJ, USA., Mehrazin R; Icahn School of Medicine at Mount Sinai, New York, NY, USA., Abaza R; Central Ohio Urology Group, Columbus, OH, USA., Stifelman MD; Hackensack University Medical Center, Hackensack, NJ, USA., Kaouk J; Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA., Crivellaro S; Department of Urology, University of Illinois, Chicago, IL, USA., Badani KK; Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: ketan.badani@mountsinai.org. |
| المصدر: | European urology focus [Eur Urol Focus] 2023 Nov; Vol. 9 (6), pp. 1059-1064. Date of Electronic Publication: 2023 Jun 30. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier B.V Country of Publication: Netherlands NLM ID: 101665661 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2405-4569 (Electronic) Linking ISSN: 24054569 NLM ISO Abbreviation: Eur Urol Focus Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Amsterdam : Elsevier B.V., [2015]- |
| مواضيع طبية MeSH: | Robotic Surgical Procedures*/methods , Kidney Neoplasms*/surgery , Kidney Neoplasms*/pathology, Humans ; Male ; Middle Aged ; Aged ; Female ; Retrospective Studies ; Nephrectomy/methods ; Kidney/surgery |
| مستخلص: | 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 Participants: This 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 χ 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. Patient Summary: The use of a single port (SP) is a novel technology for performing robotic surgery. Robotic-assisted partial nephrectomy (RAPN) is a surgery to remove a portion of the kidney due to kidney cancer. Depending on patient characteristics and surgeons' preference, SP can be performed via two approaches for RAPN: through the abdomen or through the space behind the abdominal cavity. We compared outcomes between these two approaches for patients receiving SP RAPN, finding that they were comparable. We conclude that 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. (Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Kidney cancer; Minimal invasive surgery; Partial nephrectomy; Retroperitoneal; Robotic; Single port |
| تواريخ الأحداث: | Date Created: 20230702 Date Completed: 20231219 Latest Revision: 20240111 |
| رمز التحديث: | 20240111 |
| DOI: | 10.1016/j.euf.2023.06.004 |
| PMID: | 37394396 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 2405-4569 |
|---|---|
| DOI: | 10.1016/j.euf.2023.06.004 |