Mp56-11 Single Port Advanced Research Consortium (Sparc). Single Port Access Comparison for Retro-Peritoneal Robotic Partial Nephrectomy: Individualizing Surgical Approach

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (MP56) 1 May 2024MP56-11 SINGLE PORT ADVANCED RESEARCH CONSORTIUM (SPARC). SINGLE PORT ACCESS COMPARISON FOR RETRO-PERITONEAL ROBOTIC PARTIAL NEPHRECTOMY: INDIVIDUALIZING SURGICAL APPROACH Laura Zuluaga, Kennedy E. Okhawere, Shirin Razdan, Indu Saini, Burak Upcinar, Jenna Worth, Ruben C. Sauer, Michael Raver, Nicolas Soputro, Basil Kaufmann, Craig Rogers, Ronney Abaza, Simone Crivellaro, Phillip Pierorazio, Nirmish Singla, Jihad Kaouk, Michael Stifelman, Reza Mehrazin, Ketan Badani, and Mutahar Ahmed Laura ZuluagaLaura Zuluaga, Kennedy E. OkhawereKennedy E. Okhawere, Shirin RazdanShirin Razdan, Indu SainiIndu Saini, Burak UpcinarBurak Upcinar, Jenna WorthJenna Worth, Ruben C. SauerRuben C. Sauer, Michael RaverMichael Raver, Nicolas SoputroNicolas Soputro, Basil KaufmannBasil Kaufmann, Craig RogersCraig Rogers, Ronney AbazaRonney Abaza, Simone CrivellaroSimone Crivellaro, Phillip PierorazioPhillip Pierorazio, Nirmish SinglaNirmish Singla, Jihad KaoukJihad Kaouk, Michael StifelmanMichael Stifelman, Reza MehrazinReza Mehrazin, Ketan BadaniKetan Badani, and Mutahar AhmedMutahar Ahmed View All Author Informationhttps: //doi. org/10. 1097/01. JU. 0001008940. 44711. d4. 11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Single-Port (SP) robotic-assisted partial nephrectomy (RAPN) has proven to be a viable and safe alternative to the multiport platform (MP). However, a unique advantage of SP is its ability to accommodate individual patient anatomy, allowing for a personalized surgical approach. We assessed surgical outcomes of SP RAPN via different retroperitoneal access locations, to better understand its potential impact in patient outcomes. METHODS: Using data from the Single Port Advanced Research Consortium (SPARC) database, we conducted a retrospective analysis of 77 patients who underwent retro-peritoneal SP RAPN for a renal mass between 2018 and 2023. Sixteen access types were categorized into three groups: anterior abdominal as Group 1, lateral flank as Group 2, and low anterior access as Group 3. Baseline characteristics, perioperative and postoperative data were compared between accesses using One-way ANOVA; Kruskal-Wallis rank sum test; Fisher's exact test. A post hoc analysis using Tukey HSD test to evaluate potential differences between these groups was done. RESULTS: In the study of 77 patients, 30 (39%) were female with a mean age of 60 (SD 12) years and an average BMI of 30. 2 kg/m² (SD). Group-wise baseline characteristics were similar, except for the R. E. N. A. L score, which was significantly different (p<0. 001) ; Group 1 had a median score of 4, Group 2 had 8, and Group 3 scored 5. Tumor location analysis revealed 1 anterior tumor (14%) in Group 1, 4 (15%) in Group 2, and 10 (23%) in Group 3. Posterior tumors were present in 1 patient (14%) in Group 1, 19 (73%) in Group 2, and 14 (32%) in Group 3. For unclassified tumors, Group 1 had 5 (71%), Group 2 had 3 (12%), and Group 3 had 20 (45%). Perioperative operative time varied significantly (p<0. 001), averaging 156 minutes for Group 1, 101 for Group 2, and 134 for Group 3. The length of hospital stay was shorter for Group 3, with 18 patients (41%) staying less than a day (p=0. 003). There were no intraoperative complications, conversions, or discrepancies in the rates of positive surgical margins across all groups. CONCLUSIONS: This study reveals the successful SP retroperitoneal management of high complexity tumors through low anterior access methods, proving it's adaptability in tumor manipulation. For addressing posterior tumors, the preferred approach remains lateral flank access, whereas for endophytic and midline tumors, low anterior access is the recommended choice. Notably, it was observed that the utilization of anterior abdominal access points necessitates a longer surgical time compared to lateral flank and low anterior approaches. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc. FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e930 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc. Metrics Author Information Laura Zuluaga More articles by this author Kennedy E. Okhawere More articles by this author Shirin Razdan More articles by this author Indu Saini More articles by this author Burak Upcinar More articles by this author Jenna Worth More articles by this author Ruben C. Sauer More articles by this author Michael Raver More articles by this author Nicolas Soputro More articles by this author Basil Kaufmann More articles by this author Craig Rogers More articles by this author Ronney Abaza More articles by this author Simone Crivellaro More articles by this author Phillip Pierorazio More articles by this author Nirmish Singla More articles by this author Jihad Kaouk More articles by this author Michael Stifelman More articles by this author Reza Mehrazin More articles by this author Ketan Badani More articles by this author Mutahar Ahmed More articles by this author Expand All Advertisement PDF downloadLoading. . .