title: Transperitoneal versus retroperitoneal robotic partial nephrectomy: matched-pair comparisons by nephrometry scores.
abstract: OBJECTIVE
  The purpose of this study was to compare perioperative outcomes of transperitoneal (TP) and retroperitoneal (RP) robot-assisted partial nephrectomy (RPN) by matched analysis using nephrometry systems.
  
  
  METHODS
  A total of 107 patients who underwent RPN by a single surgeon from December 2008 to June 2012 were analyzed; 57 patients underwent TP RPN and 50 patients underwent RP RPN. Baseline demographic characteristics, perioperative outcomes and changes in renal function were collected by retrospective review of medical records. Matched-pair comparisons were done using RENAL score and C-index.
  
  
  RESULTS
  No significant difference was observed between TP and RP RPN in patient age, body mass index, gender, laterality, clinical stage, tumor size, RENAL score or ASA score. The TP RPN had more cystic renal masses (TP vs. RP = 33 vs. 12 %, p = 0.012) and RP RPN had shorter median operation times (150 vs. 120 min, p = 0.015) and shorter mean warm ischemic times (26.2 vs. 22.6 min, p = 0.040) than TP RPN. In the matched-pair analysis, RP RPN showed shorter operation times with similar warm ischemic times. Estimated blood loss and visual analog pain scales showed no significant differences between groups. A total of 12 (11.4 %) postoperative complications occurred, all Clavien class I or II with no significant difference in incidence.
  
  
  CONCLUSIONS
  Retroperitoneal robot-assisted partial nephrectomy showed shorter operation time and generally equivalent perioperative results to TP RPN. RP RPN is a viable treatment option for treating posterior or lateral renal masses.
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea.
authors.forename: Seol Ho
authors.initials: SH
authors.lastname: Choo
authors.forename: Seo Yeon
authors.initials: SY
authors.lastname: Lee
authors.forename: Hyun Hwan
authors.initials: HH
authors.lastname: Sung
authors.forename: Hwang Gyun
authors.initials: HG
authors.lastname: Jeon
authors.forename: Byong Chang
authors.initials: BC
authors.lastname: Jeong
authors.forename: Seong Soo
authors.initials: SS
authors.lastname: Jeon
authors.forename: Hyun Moo
authors.initials: HM
authors.lastname: Lee
authors.forename: Han Yong
authors.initials: HY
authors.lastname: Choi
authors.forename: Seong Il
authors.initials: SI
authors.lastname: Seo
mesh_terms: D018249:Adenoma, Oxyphilic / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D018207:Angiomyolipoma / Q000473:pathology / Q000601:surgery; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D061646:Operative Time; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome