PMID- 24044768
OWN - NLM
STAT- MEDLINE
DCOM- 20140526
LR  - 20181202
IS  - 1557-900X (Electronic)
IS  - 0892-7790 (Linking)
VI  - 27
IP  - 11
DP  - 2013 Nov
TI  - Comparison of the transperitoneal and retroperitoneal approach in robot-assisted 
      partial nephrectomy in an initial case series in Japan.
PG  - 1384-8
LID - 10.1089/end.2012.0641 [doi]
AB  - PURPOSE: To compare the results from the transperitoneal and retroperitoneal 
      approaches in our initial case series of robot-assisted partial nephrectomy 
      (RAPN) in terms of surgical time, renal artery clamping time, postoperative renal 
      function, adverse events, and surgical margin status. PATIENTS AND METHODS: The 
      initial 26 consecutive RAPNs performed for solid renal tumors in our hospital 
      were categorized by the approach used, transperitoneal or retroperitoneal, and 
      compared for body mass index, tumor size, R.E.N.A.L. nephrometry score, PADUA 
      score, tumor location, surgical time, renal artery clamping time, renal function 
      change after surgery, operative blood loss, surgical margin status, and adverse 
      events (AEs). RESULTS: The median tumor size was 25 mm (range 15-50). A 
      transperitoneal approach was used in 16 patients and a retroperitoneal approach 
      was used in 10 patients. There was no significant difference in renal tumor and 
      patient characteristics between the two groups except tumor location (anterior 
      tumor was significantly more in the transperitoneal approach and posterior tumor 
      was significantly more in retroperitoneal approach (P=0.0144 and P=0.0100, 
      respectively)). Operative time (239 +/- 63.0 minutes in the transperitoneal group 
      vs. 193 +/- 40.6 minutes in the retroperitoneal group), warm ischemic time (24.3 +/- 
      9.07 minutes in the transperitoneal group vs. 24.7 +/- 8.35 minutes in the 
      retroperitoneal group) and AEs (1/16 in the transperitoneal group vs. 1/10 in the 
      retroperitoneal group; both cases were Clavien-Dindo grade I) did not show any 
      significant difference between the two approaches (P=0.0792, 0.5485, and 0.7270, 
      respectively). CONCLUSIONS: The retroperitoneal approach in RAPN appears to be a 
      safe and technically feasible minimally invasive option for nephron-sparing 
      surgery, based on our initial case series, and showed equivalent outcomes to 
      those of the transperitoneal approach even though it was an initial robotic renal 
      surgery series. Future studies, including a larger number of cases, are planned 
      to draw more definitive conclusions.
FAU - Tanaka, Kazushi
AU  - Tanaka K
AD  - Division of Urology, Department of Surgery Related, Kobe University Graduate 
      School of Medicine , Kobe, Japan .
FAU - Shigemura, Katsumi
AU  - Shigemura K
FAU - Furukawa, Junya
AU  - Furukawa J
FAU - Ishimura, Takeshi
AU  - Ishimura T
FAU - Muramaki, Mototsugu
AU  - Muramaki M
FAU - Miyake, Hideaki
AU  - Miyake H
FAU - Fujisawa, Masato
AU  - Fujisawa M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20130917
PL  - United States
TA  - J Endourol
JT  - Journal of endourology
JID - 8807503
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - Japan
MH  - Kidney Neoplasms/*surgery
MH  - Laparoscopy/*methods
MH  - Male
MH  - Middle Aged
MH  - Nephrectomy/*methods
MH  - Operative Time
MH  - Retroperitoneal Space/surgery
MH  - Robotics/*methods
MH  - Treatment Outcome
EDAT- 2013/09/21 06:00
MHDA- 2014/05/27 06:00
CRDT- 2013/09/19 06:00
PHST- 2013/09/19 06:00 [entrez]
PHST- 2013/09/21 06:00 [pubmed]
PHST- 2014/05/27 06:00 [medline]
AID - 10.1089/end.2012.0641 [doi]
PST - ppublish
SO  - J Endourol. 2013 Nov;27(11):1384-8. doi: 10.1089/end.2012.0641. Epub 2013 Sep 17.