Comparison of lateral flank approach and low anterior access for single port (SP) retroperitoneal partial nephrectomy: an analysis from the single port advanced research consortium (SPARC).

التفاصيل البيبلوغرافية
العنوان:	Comparison of lateral flank approach and low anterior access for single port (SP) retroperitoneal partial nephrectomy: an analysis from the single port advanced research consortium (SPARC).
المؤلفون:	Razdan S; Department of Urology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA. shirinrazdan1@gmail.com., Okhawere KE; Department of Urology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA., Zuluaga L; Department of Urology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA., Saini I; Department of Urology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA., Ucpinar B; Department of Urology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA., Sauer RC; Department of Urology, University of Illinois, Chicago, IL, USA., Soputro N; Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA., Crivellaro S; Department of Urology, University of Illinois, Chicago, IL, USA., Kaouk JH; Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA., Ahmed M; Hackensack University Medical Center, Hackensack, NJ, USA., Stifelman MD; Hackensack University Medical Center, Hackensack, NJ, USA., Badani KK; Department of Urology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA.
المصدر:	Journal of robotic surgery [J Robot Surg] 2024 May 18; Vol. 18 (1), pp. 216. Date of Electronic Publication: 2024 May 18.
نوع المنشور:	Journal Article; Comparative Study
اللغة:	English
بيانات الدورية:	Publisher: Springer Country of Publication: England NLM ID: 101300401 Publication Model: Electronic Cited Medium: Internet ISSN: 1863-2491 (Electronic) Linking ISSN: 18632483 NLM ISO Abbreviation: J Robot Surg Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: London : Springer
مواضيع طبية MeSH:	Nephrectomy/methods , Robotic Surgical Procedures/methods , Kidney Neoplasms*/surgery, Humans ; Female ; Male ; Retroperitoneal Space/surgery ; Middle Aged ; Retrospective Studies ; Aged ; Operative Time ; Treatment Outcome ; Length of Stay/statistics & numerical data
مستخلص:	Single Port (SP) robotic partial nephrectomy (RPN) can be performed via retroperitoneal and transperitoneal approach. We aim to compare outcomes of two commonly described incisions for retroperitoneal SP RPN: lateral flank approach (LFA) and low anterior access (LAA). We performed a retrospective study of patients who underwent SP retroperitoneal RPN from 2018 to 2023 as part of a large multi-institute collaboration (SPARC). Baseline demographic, clinical, tumor-specific characteristics, and perioperative outcomes were compared using χ2, t test, Fisher exact test, and Mann-Whitney U test. Multivariable analyses were conducted using robust and logistic regressions. A total of 70 patients underwent SP retroperitoneal RPN, with 44 undergoing LAA. Overall, there were no significant differences in baseline characteristics between the two groups. The LAA group exhibited significantly lower median RENAL scores (8 vs. 5, p < 0.001) and more varied tumor locations (p = 0.002). In the bivariate analysis, there were no statistically significant differences in ischemia time, estimated blood loss, or complication rates between the groups. However, the LAA group had longer operative times (101 vs. 134 min, p < 0.001), but was more likely to undergo a same-day discharge (p < 0.001). When controlling for other variables, LAA was associated with shorter ischemia time (p = 0.005), but there was no significant difference in operative time (p = 0.348) and length of stay (p = 0.122). Both LFA and LAA are acceptable approaches for SP retroperitoneal RPN with comparable perioperative outcomes. This early data suggests the LAA is more versatile for varying tumor locations; however, larger cohort studies are needed to ascertain whether there is an overall difference in patient recovery. (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
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فهرسة مساهمة:	Keywords: Partial nephrectomy; Patient positioning; Robotics; Single port; Surgical access
تواريخ الأحداث:	Date Created: 20240518 Date Completed: 20240518 Latest Revision: 20240518
رمز التحديث:	20240519
DOI:	10.1007/s11701-024-01969-9
PMID:	38761306
قاعدة البيانات:	MEDLINE

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تدمد:	1863-2491
DOI:	10.1007/s11701-024-01969-9