Comparison of the Perioperative Outcomes of Robot-Assisted Laparoscopic Transperitoneal Versus Retraperitoneal Partial Nephrectomy for Posterior-Lateral Renal Tumors: A Systematic Review and Meta-Analysis - Beyond the Abstract

The incidence of renal cancer has been on the rise in recent years, and for T1a and some T2b renal cancers, guidelines recommend partial nephrectomy. However, controversy surrounds the optimal surgical approach (transabdominal versus retroperitoneal) for partial nephrectomy in treating early-stage renal cancer based on tumor location.

Therefore, the primary objective of our meta-analysis is to assess the perioperative outcomes of robotic-assisted partial nephrectomy (RAPN) for posterior-lateral renal tumors through a comparison of transperitoneal (TP) and retroperitoneal (RP) approaches, drawing on a thorough review of the current literature. Our aim was to compare the advantages of RP-RAPN versus TP-RAPN in the perioperative outcomes of posterior posterior-lateral renal tumors, in order to offer evidence-based medicine for the selection of surgical approaches and provide patients with a more reliable treatment option for such tumors.

According to the currently available evidence, RP-RAPN has some advantages in operative time, estimated blood loss, and length of hospital stay compared with TP-RAPN. There was no statistical difference between the two methods in terms of warm ischemia time, complications, or positive surgical margin. So the emergence of such results suggests that the selection of RP-RAPN might produce better perioperative outcomes when treating posterior posterior-lateral renal tumors and provide evidence-based medical evidence for clinicians.

Currently, our evidence only compares perioperative outcomes, and due to the lack of long-term oncological outcomes available for analysis in our included studies, more studies with long-term follow-up are needed to determine the long-term clinical efficacy of the two surgical accesses for the treatment of posterior-lateral renal tumors.

Written by:

  • Tao Wu, Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.
  • Pengjun Xu, Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China
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