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Title: Comparison of perioperative outcomes following transperitoneal versus retroperitoneal robot-assisted partial nephrectomy: a propensity-matched analysis of VCQI database.
Epworth Authors: Moon, Daniel
Other Authors: Sharma, Gopal
Shah, Milap
Ahluwalia, Puneet
Dasgupta, Dasgupta
Challacombe, Benjamin
Bhandari, Mahendra
Ahlawat, Rajesh
Rawal, Sudhir
Buffi, Nicolo
Sivaraman, Ananthkrishnan
Porter, James
Rogers, Craig
Mottrie, Alexandre
Abaza, Ronney
Ho Rha, Khoon
Yuvaraja, Thyavihally
Parekh, Dipen
Capitanio, Umberto
Maes, Kris
Porpiglia, Francesco
Turkeri, Levent
Gautam, Gagan
Keywords: Partial Nephrectomy
Propensity Matching
Robot-Assisted Partial Nephrectomy
Transperitoneal Robot-Assisted Partial Nephrectomy
Vattikuti Collective Quality Initiative
RENAL Nephrometry Scores
Estimated Glomerular Filtration Rate
Serum Creatinine
Intraoperative Complications
Epworth Prostate Centre, Epworth HealthCare, Victoria, Australia
Issue Date: Jul-2022
Publisher: Springer
Citation: World J Urol . 2022 Jul 22
Abstract: Objective: To compare perioperative outcomes following retroperitoneal (RPRAPN) and transperitoneal robot-assisted partial nephrectomy (TPRAPN). Methods: With this Vattikuti Collective Quality Initiative (VCQI) database, study propensity scores were calculated according to the surgical access (TPRAPN and RPRAPN) for the following independent variables, i.e., age, sex, side of the surgery, RENAL nephrometry scores (RNS), estimated glomerular filtration rate (eGFR) and serum creatinine. The study's primary outcome was the comparison of trifecta between the two groups. Results: In this study, 309 patients who underwent RPRAPN were matched with 309 patients who underwent TPRAPN. The two groups matched well for age, sex, tumor side, polar location of the tumor, RNS, preoperative creatinine and eGFR. Operative time and warm ischemia time were significantly shorter with RPRAPN. Intraoperative blood loss and need for blood transfusion were lower with RPRAPN. There was a significantly higher number of intraoperative complications with RPRAPN. However, there was no difference in the two groups for postoperative complications. Trifecta outcomes were better with RPRAPN (70.2% vs. 53%, p < 0.0001) compared to TPRAPN. We noted no significant change in overall results when controlled for tumor location (anteriorly or posteriorly). The surgical approach, tumor size and RNS were identified as independent predictors of trifecta on multivariate analysis. Conclusion: RPRAPN is associated with superior perioperative outcomes in well-selected patients compared to TPRAPN. However, the data for the retroperitoneal approach were contributed by a few centers with greater experience with this technique, thus limiting the generalizability of the results of this study.
DOI: 10.1007/s00345-022-04101-4
PubMed URL:
ISSN: 0724-4983
Journal Title: World Journal of Urology
Type: Journal Article
Affiliated Organisations: Department of Urologic Oncology, Max Institute of Cancer Care, Saket, New Delhi, India.
King's College, King's Health Partners, London, UK
Guy's and St. Thomas' NHS Foundation Trust, London, UK
Vattikuti Foundation, Detroit, MI, USA
The Medicity Hospital, New Delhi, India.
Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
Humanitas Research Hospital, Rozzano, MI, Italy.
Chennai Urology and Robotics Institute, Chennai, India
Swedish Medical Center, Seattle, WA, USA.
Henry Ford Hospital, Detroit, MI, USA
ORSI Academy, Melle, Belgium
Central Ohio Urology Group, Mount Carmel Health System Prostate Cancer Program, Columbus, OH, USA
Yonsei University Health System, Seoul, South Korea
Peter MacCallum Hospital, University of Melbourne, Royal Melbourne Clinical School, Melbourne, Australia.
Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
University of Miami Health System, Miami, FL, USA
Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Milan, Italy
Center for Robotic and Minimally Invasive Surgery, Hospital Da Luz, Luz Sáude, Portugal
San Luigi Gonzaga Hospital of Orbassano, Turin, Italy
Acıbadem M.A., Department of Urology, Aydınlar University, Altuzinade Hospital, Istanbul, Turkey
Department of Urologic Oncology, Max Institute of Cancer Care, Saket, New Delhi, India
Type of Clinical Study or Trial: Comparative Study
Appears in Collections:Epworth Prostate Centre

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