Comparison of the results of laparoscopic retroperitoneal and transperitoneal partial nephrectomy in anterior kidney tumors: a two-center matched-pair analysis.

Purpose: To compare the intraoperative, postoperative and pathologic results of transperitoneal (TLPN) and retroperitoneal (RLPN) laparoscopic partial nephrectomy for anterior renal tumors.

Methods: Data of the 401 patients in two different centers, who had LPN operations due to anteriorly placed renal tumor with RLPN and TLPN approaches, were analyzed retrospectively. Demographic, tumor characteristics, intraoperative, postoperative and pathologic data of all patients were evaluated. 74 TLPN cases were matched with 74 RLPN cases with respect to age, body mass index, tumor size and PADUA nephrometry score (matched 1:1). The groups were compared according to the parameters above.

Results: The two groups were similar in terms of clinical data and tumor characteristics, including matching parameters. The median operative time was similar between two groups (115 vs. 110 min, p = 0.235; 20 vs. 22.5 min, p = 0.283 in the RLPN group than in the TLPN group, respectively). Intraoperative complication rates were similar between the groups (6.8% in RLPN group vs. 10.8% in TLPN group, p = 0.384). The median amount of bleeding in the TLPN group was statistically higher than in the RLPN group (150 vs. 50 cc, p < 0.001). There were no difference in terms of postoperative complication rates and the rate of residual tumor presence (9.5% in RLPN group vs. 12.2% in TLPN group, p = 0.144; 6.8% in the RLPN group, 5.4% in the TLPN group, p = 0.731,respectively).

Conclusion: In high-volume centers, both transperitoneal and retroperitoneal procedures yield comparably favourable outcomes for anterior kidney tumors. Thus, tumor location should not be regarded as a deterrent to considering RLPN.