This study aimed to compare the antero-lateral and posterior localized renal masses in laparoscopic partial nephrectomy with the retroperitoneal approach in terms of operative, functional, and oncological outcomes. Patients who underwent retroperitoneal laparoscopic partial nephrectomy by a single surgeon between January 2013 and January 2021 were included in the study. A one-to-one propensity score matching (PSM) analysis was conducted to obtain two balanced groups. The patients were divided into two groups as posterior and antero-lateral according to the localization of the mass. A total of 239 patients were included in the PSM analysis, with 65 patients allocated to each group. The mean operative time was 79.2 ± 11.2 min in the posterior group, while it was 90.0 ± 11.6 min in the antero-lateral group (P < 0.001). Warm ischemia time was 15.9 ± 2.4 min in the posterior group and 18.6 ± 2.7 min in the antero-lateral group (P < 0.001). The median decrease in eGFR at 1 year was 4.8 (IQR, 2.9-6.9) mL/min in the posterior group and 5.0 (IQR, 2.8-11) mL/min in the antero-lateral group (P = 0.219). The warm ischemia time and clamping technique were found to be significant factors for predicting eGFR change after surgery (β:0.693, 95% CI: 0.39-0.99, P < 0.001; β:6.43, 95% CI: 1.1-11.7, P = 0.017, respectively). We report that retroperitoneal laparoscopic partial nephrectomy provided longer warm -ischemia and operative time for antero-lateral renal masses than posterior masses. However, long-term oncological and functional results were similar for both localizations.
Journal of kidney cancer and VHL. 2023 Jul 10*** epublish ***
Hakan Anıl, Ali Yıldız, Ahmet Güzel, Serkan Akdemir, Kaan Karamık, Murat Arslan
Department of Urology, Adana Seyhan State Hospital, Adana, Turkey., Department of Urology, Faculty of Medicine, Okan University Hospital, Istanbul, Turkey., Department of Urology, Aydın State Hospital, Aydın, Turkey., Department of Urology, Private Tınaztepe Hospital, İzmir, Turkey., Department of Urology, Korkuteli State Hospital, Antalya, Turkey.