Milan H Patel, Ruben Blachman-Braun, Lauren Loebach, Braden Millan, Jaskirat Saini, Sandeep Gurram, W Marston Linehan, Mark W Ball
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引用次数: 0
Abstract
Purpose: To present our experience with re-operative retroperitoneal partial nephrectomy (Re-RetroPN), evaluate its feasibility and safety, and compare perioperative outcomes, including renal function metrics, pathology, and complication rates, between patients that underwent Re-RetroPN and those that underwent re-operative transperitoneal robotic partial nephrectomy (Re-TransPN).
Methods: A retrospective cohort study was conducted identifying patients who underwent re-operative robotic partial nephrectomy (PN) at our institution from January 2008 to December 2024. Demographic, clinical, perioperative, and pathological data were recorded and analyzed.
Results: A total of 186 patients who underwent robotic re-operative PN were analyzed (173 Re-TransPN vs. 13 Re-RetroPN), and 1 patient was converted from Re-RetroPN to Re-TransPN. Overall, 17 (9.1%) had a solitary kidney, 138 (74.2%) underwent their second ipsilateral partial nephrectomy, and 48 (25.8%) had their third. A total of 894 tumors were removed (825 with Re-TransPN, 69 with Re-RetroPN), with a median of 3 (2-6) tumors per procedure. Perioperative metrics, including estimated blood loss, operative time, and percentage of cases performed without hilar clamping were similar between groups. Positive surgical margins were observed in 7 (4.0%) patients in the Re-TransPN group, with no positive margins reported in the Re-RetroPN group. Renal function parameters at 3 months and complication rates were comparable between groups, with 1 (7.7%) patient in the Re-RetroPN group experiencing a Clavien-Dindo grade ≥3 complications.
Conclusion: Re-RetroPN is a feasible and safe option for carefully selected patients, with comparable outcomes to Re-TransPN. It provides advantages in certain scenarios, such as improved access to posteriorly located tumors and avoidance of the peritoneal cavity.
期刊介绍：
Urologic Oncology: Seminars and Original Investigations is the official journal of the Society of Urologic Oncology. The journal publishes practical, timely, and relevant clinical and basic science research articles which address any aspect of urologic oncology. Each issue comprises original research, news and topics, survey articles providing short commentaries on other important articles in the urologic oncology literature, and reviews including an in-depth Seminar examining a specific clinical dilemma. The journal periodically publishes supplement issues devoted to areas of current interest to the urologic oncology community. Articles published are of interest to researchers and the clinicians involved in the practice of urologic oncology including urologists, oncologists, and radiologists.
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