Transperitoneal Versus Retroperitoneal Robotic-Assisted Partial Nephrectomy in Patients with Obesity.

Journal of laparoendoscopic & advanced surgical techniques. Part A(2023)

引用 0|浏览21
暂无评分
摘要
We aim to compare transperitoneal (TP) and retroperitoneal (RP) robotic partial nephrectomy (RPN) in obese patients. Obesity and RP fat can complicate RPN, especially in the RP approach where working space is limited. Using a multi-institutional database, we analyzed 468 obese patients undergoing RPN for a renal mass (86 [18.38%] RP, 382 [81.62%] TP). Obesity was defined as body mass index >30 kg/m. A 1:1 propensity score matching was performed adjusting for age, previous abdominal surgery, tumor size, R.E.N.A.L nephrometry score, tumor location, surgical date, and participating centers. Baseline characteristics and perioperative and postoperative data were compared. In the propensity score-matched cohort, 79 (50%) TP patients were matched with 79 (50%) RP patients. The RP group had more posterior tumors (67 [84.81%], RP versus 23 [29.11%], TP;  < .001), while the other baseline characteristics were comparable. Warm ischemia time (interquartile range; 15 [11-20], RP versus 14 [10-17] minutes, TP;  = .216), operative time (129 [116-165], RP versus 130 [95-180] minutes, TP;  = .687), estimated blood loss (50 [50-100], RP versus 75 [50-150] mL, TP;  = .129), length of stay (1 [1-1], RP versus 1 [1-2] day, TP;  = .319), and major complication rate (1 [1.27%], RP versus 3 [3.80%], TP;  = .620) were similar. No significant difference was observed in positive surgical margin rate and delta estimated glomerular filtration at follow-up. TP and RP RPN yielded similar perioperative and postoperative outcomes in obese patients. Obesity should not be a factor in determining optimal approach for RPN.
更多
查看译文
关键词
obesity,robotic-assisted
AI 理解论文
溯源树
样例
生成溯源树,研究论文发展脉络
Chat Paper
正在生成论文摘要