Mp44-18 Comparison of Lateral Flank Approach and Low Anterior Access for Single Port (Sp) Retroperitoneal Partial Nephrectomy: An Analysis From the Single Port Advanced Research Consortium (Sparc)

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy III (MP44)1 May 2024MP44-18 COMPARISON OF LATERAL FLANK APPROACH AND LOW ANTERIOR ACCESS FOR SINGLE PORT (SP) RETROPERITONEAL PARTIAL NEPHRECTOMY: AN ANALYSIS FROM THE SINGLE PORT ADVANCED RESEARCH CONSORTIUM (SPARC) Shirin Razdan, Kennedy E. Okhawere, Laura Zuluaga, Indu Saini, Burak Upcinar, Ruben Calvo Sauer, Nicholas Soputro, Ronney Abaza, Simone Crivellaro, J. H. Kaouk, Michael Stifelman, Reza Mehrazin, Ketan K. Badani, and Mutahar Ahmed Shirin RazdanShirin Razdan , Kennedy E. OkhawereKennedy E. Okhawere , Laura ZuluagaLaura Zuluaga , Indu SainiIndu Saini , Burak UpcinarBurak Upcinar , Ruben Calvo SauerRuben Calvo Sauer , Nicholas SoputroNicholas Soputro , Ronney AbazaRonney Abaza , Simone CrivellaroSimone Crivellaro , J. H. KaoukJ. H. Kaouk , Michael StifelmanMichael Stifelman , Reza MehrazinReza Mehrazin , Ketan K. BadaniKetan K. Badani , and Mutahar AhmedMutahar Ahmed View All Author Informationhttps://doi.org/10.1097/01.JU.0001009508.69111.d0.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Single Port (SP) robotic partial nephrectomy (RPN) can be performed via retroperitoneal and transperitoneal approach. We aim to compare outcomes of two commonly described incisions for retroperitoneal SP RPN: lateral flank approach (LFA) and low anterior access (LAA). METHODS: We performed a retrospective study of patients who underwent SP retroperitoneal RPN as part of a large multi-institute collaboration (SPARC). Baseline demographic, clinical, tumor-specific characteristics, and perioperative outcomes were compared using χ2, t-test, Fisher exact test, and Mann–Whitney U test. Multivariable analyses were conducted using robust and logistic regressions. RESULTS: A total of 70 patients underwent SP retroperitoneal RPN from 2018-2023. Twenty-six patients underwent LFA, and 44 LAA. Overall, there were no significant differences in baseline characteristics between the two groups. There were differences in tumor characteristics, with the LAA group having significantly lower median RENAL scores (8 vs. 5, p<0.001) and more varied tumor locations (p=0.002). On univariate analysis, there was no significant difference between approaches in ischemia time, estimated blood loss, conversion rates, or complication rates. The LAA group had longer operative times (101 vs. 134 min, p<0.001), but was more likely to undergo a same day discharge (p<0.001). There was no difference in positive margin status. On multivariate analysis, LAA was associated with shorter ischemia time (p=0.005), but there was no significant difference in operative time (p=0.348) and length of stay (p=0.122). CONCLUSIONS: Both LFA and LAA are acceptable approaches for SP retroperitoneal RPN with comparable perioperative outcomes. Larger cohort studies are needed to ascertain whether there is greater versatility of LAA over LFA for patient recovery. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e738 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Shirin Razdan More articles by this author Kennedy E. Okhawere More articles by this author Laura Zuluaga More articles by this author Indu Saini More articles by this author Burak Upcinar More articles by this author Ruben Calvo Sauer More articles by this author Nicholas Soputro More articles by this author Ronney Abaza More articles by this author Simone Crivellaro More articles by this author J. H. Kaouk More articles by this author Michael Stifelman More articles by this author Reza Mehrazin More articles by this author Ketan K. Badani More articles by this author Mutahar Ahmed More articles by this author Expand All Advertisement PDF downloadLoading ...