Transperitoneal versus retroperitoneal laparoscopic radical nephrectomy: A comparison of clinical outcomes / 第二军医大学学报

ABSTRACT

Objective To compare clinical outcomes of transperitoneal and retroperitoneal laparoscopic radical nephrectomy for renal cell carcinoma (RCC) and to identify the indicators for each approach. Methods A total of 258 patients underwent transperitoneal (n = 116) or retroperitoneal (n = 142) laparoscopic radical nephrectomy for RCC. The operation time, blood loss during operation, fasting period after surgery and hospital stay were compared between the two groups. Results The operation timewas 80-315 min (a mean of [167 ±66. 8] min) for transperitoneal approach and 85-280 min (a mean of [152± 48.8] min) for retroperitoneal approach (P = 0. 034). The blood loss was 50-1,000 ml (a mean of [181±140. 4] ml) for transperitoneal approach and 50-800 ml (a mean of [171 ± 132. 9] ml) for retroperitoneal approach(P = 0. 544). The fasting period of surgery was 1-5 d (a mean of [2. 8±1. 3] d) for transperitoneal approach and 1-5 d (a mean of [2. 9 ±1. 2] d) for retroperitoneal approach(P = 0. 801). The hospital stay was 3-9 d (a mean of [6. 6±1. 5] d) for transperitoneal approach and 3-8 d (a mean of [6. 5±1. 6] d) for retroperitoneal approach(P = 0. 477). Conclusion Transperitoneal and retroperitoneal approaches both can yield satisfactory surgical outcomes in laparoscopic radical nephrectomy. The transperitoneal approach is suitable for tumors with a larger size.